scholarly journals Haemodynamic Effects of Pericardial Closure after Cardiac Surgery

2020 ◽  
Vol 8 (1) ◽  
pp. 81-85
Author(s):  
Saurabh KS ◽  
AK Padhy ◽  
Madhur Kumar ◽  
R Munjal ◽  
A. Gupta
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Venous Pressure ◽  
Left Ventricular ◽  
Haemodynamic Effects ◽  
Bypass Grafting ◽  
Central Venous ◽  
Double Valve Replacement

Introduction: Whether pericardial closure should be done or not is still a debated topic. While many studies favour pericardial closure after cardiac surgery, many are still not in favour of the same. Objective : Objective of this study was to analyse the changes induced by pericardial closure on the haemodynamic of the patient using easily measurable variables. Methods : Data of 30 patients were analysed of which 14 underwent mitral valve replacement, 10 underwent coronary artery bypass grafting and 6 underwent double valve replacement. Results: There was statistically significant change in cardiac output (p<0.01), central venous pressure (p<0.05) and left ventricular end diastolic diameter (p<0.01) after pericardial closure. Clinically the pericardial closure was well tolerated. Conclusion: Despite exhaustive experience, the topic of closing pericardium is still debated. Our study shows that clinically pericardial closure is well tolerated and in return it also safeguards the risks associated with re-do operations

scholarly journals Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aditya Eranki ◽  
Claudia Villanueva ◽  
Nicholas Collins ◽  
Peng Seah
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Ventricular Thrombus

Abstract Introduction Left ventricular (LV) thrombus is a complication of acute myocardial infarction and is associated with systemic thromboembolism. We describe a trans-aortic endoscopic approach to the removal of an LV thrombus in a patient undergoing concurrent coronary artery bypass grafting and aortic valve replacement. Case presentation A 47 year old male presented following an embolic middle cerebral artery stroke and underwent transthoracic echocardiography demonstrating a mobile LV thrombus. Additional investigation revealed a moderately stenosed bicispid aortic valve, two vessel coronary artery disease and ischemic cardiomyopathy. The patient underwent early surgery to reduce the risk of further embolic episodes. A trans-aortic approach was utilized with videoscopy and single shafted instrumentation to aide in removal of the thrombus. The patient then underwent aortic valve replacement and coronary artery bypass grafting. Conclusion We report an alternative technique for the removal of a left ventricular thrombus in a patient undergoing concurrent coronary and aortic valve surgery. The transaortic video-assisted approach provided excellent visualisation of the apex and near complete removal of the thrombus without damaging the surrounding trabeculae. The main benefit of this technique is sparing of LV tissue, thereby preserving left ventricular function.

Acute plasma expansion: left ventricular hemodynamics and endocrine function during exercise

1992 ◽  
Vol 73 (5) ◽  
pp. 1791-1796 ◽  
Author(s):  
I. L. Kanstrup ◽  
J. Marving ◽  
P. F. Hoilund-Carlsen
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Healthy Subjects ◽  
Venous Pressure ◽  
Left Ventricular ◽  
Endocrine Function ◽  
Plasma Expansion ◽  
Central Venous ◽  
Mean Pressure ◽  
Dextran Solution

In 11 healthy subjects (8 males and 3 females, age 21–59 yr) left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volumes were measured in the supine position by isotope cardiography at rest and during two submaximal one-legged exercise loads before and 1 h after acute plasma expansion (PE) by use of a 6% dextran solution (500–750 ml). After PE, blood volume increased from 5.22 +/- 0.92 to 5.71 +/- 1.02 (SD) liters (P < 0.01). At rest, cardiac output increased 30% (5.3 +/- 1.0 to 6.9 +/- 1.6 l/min; P < 0.01), stroke volume increased from 90 +/- 20 to 100 +/- 28 ml (P < 0.05), and LVEDV increased from 134 +/- 29 to 142 +/- 40 ml (NS). LVESV was unchanged (44 +/- 11 and 42 +/- 14 ml). Heart rate rose from 60 +/- 7 to 71 +/- 10 beats/min (P < 0.01). The cardiac preload [central venous pressure (CVP)] was insignificantly elevated (4.9 +/- 2.1 and 5.3 +/- 3.0 mmHg); systemic vascular resistance and arterial pressures were significantly reduced (mean pressure fell from 91 +/- 11 to 85 +/- 11 mmHg, P < 0.01). Left ventricular peak filling and peak ejection rates both increased (19 and 14%, respectively; P < 0.05). During exercise, cardiac output remained elevated after PE compared with the control situation, predominantly due to a 10- to 14-ml rise in stroke volume caused by an increased LVEDV, whereas LVESV was unchanged. CVP increased after PE by 2.1 and 3.0 mmHg, respectively (P < 0.05).2+ remained unchanged during exercise compared with rest after PE in

scholarly journals Studies on Australian Snake Venoms. Part 1: The Haemodynamic Effects of Brown Snake (Pseudonaja) Species in the Dog

1989 ◽  
Vol 17 (4) ◽  
pp. 466-469 ◽  
Author(s):  
J. Tibballs ◽  
S. Sutherland ◽  
S. Kerr
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Venous Pressure ◽  
Haemodynamic Effects ◽  
Peripheral Vascular ◽  
Snake Venoms ◽  
Central Venous ◽  
Induced Hypotension ◽  
Mechanically Ventilated

The haemodynanic effects of Brown Snake (Pseudonaja) species (textilis, nuchalis, affinis) were investigated in anaesthetised, mechanically ventilated dogs. Blood pressure decreased to minimal levels five minutes after intravenous envenomation. Hypotension was accompanied by significant decrements in cardiac output and stroke volume and a rise in peripheral vascular resistance. Heart rate increased transiently during 0.5-2.0 minutes after envenomation but had declined below resting levels five minutes after envenomation. No statistically significant change was recorded in central venous pressure. Depression of myocardial contractility is postulated as the mechanism of venom induced hypotension.

scholarly journals Central venous pressure and cardiac function during spaceflight

1998 ◽  
Vol 85 (2) ◽  
pp. 738-746 ◽  
Author(s):  
Ronald J. White ◽  
C. Gunnar Blomqvist
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Central Venous Pressure ◽  
Shape Change ◽  
Venous Pressure ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Central Venous ◽  
End Diastolic Volume ◽  
Reference Measurements

Early in spaceflight, an apparently paradoxical condition occurs in which, despite an externally visible headward fluid shift, measured central venous pressure is lower but stroke volume and cardiac output are higher, and heart rate is unchanged from reference measurements made before flight. This paper presents a set of studies in which a simple three-compartment, steady-state model of cardiovascular function is used, providing insight into the contributions made by the major mechanisms that could be responsible for these events. On the basis of these studies, we conclude that, during weightless spaceflight, the chest relaxes with a concomitant shape change that increases the volume of the closed chest cavity. This leads to a decrease in intrapleural pressure, ultimately causing a shift of blood into the vessels of the chest, increasing the transmural filling pressure of the heart, and decreasing the central venous pressure. The increase in the transmural filling pressure of the heart is responsible, through a Starling-type mechanism, for the observed increases in heart size, left ventricular end-diastolic volume, stroke volume, and cardiac output.

Sign in / Sign up

Export Citation Format

Share Document