Complete Unloading Alone May Not Adequately Protect the Left Ventricle

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Presentation transcript:

Complete Unloading Alone May Not Adequately Protect the Left Ventricle Masashi Komeda, MD,PhD, Abe DeAnda, MD, Julie R. Glasson, MD, Ann F. Bolger, MD, George T. Daughters, MS, Neil B. Ingels, PhD, D.Craig Miller, MD The Annals of Thoracic Surgery Volume 64, Issue 5, Pages 1250-1255 (November 1997) DOI: 10.1016/S0003-4975(97)00907-7 Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Multiple pump circuit, cannulation arrangement, and pressure monitoring sites. Aortic root pressure (=coronary perfusion pressure) was controlled by adjusting the tightness of the snare as well as by altering the pump flow rate in the second arterial cannula. (a.=artery; LA=left atrial; LV=left ventricular; PA=pulmonary artery.) The Annals of Thoracic Surgery 1997 64, 1250-1255DOI: (10.1016/S0003-4975(97)00907-7) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Systolic and diastolic left ventricular function with complete left ventricular unloading on cardiopulmonary bypass (CPB) both with and without dobutamine infusion. The small schematic illustration in the upper left corner of each graph shows the trend of the variable under discussion in the high-CPP group (white arrow) and the moderate-CPP group (black arrow). (A) Left ventricular end-systolic elastance (Emax). The high-CPP group had a higher Emax and the expected response to dobutamine compared with the moderate-CPP group. (B) Left ventricular physiologic intercept (Ees100). The high-CPP group had a lower Ees100 (ie, better systolic left ventricular function) and more response (lower Ees100) to dobutamine infusion compared with the moderate-CPP group. (C) Left ventricular chamber stiffness (Sd). The high-CPP group had a higher Sd (ie, more stiff ventricular chamber) compared with the moderate-CPP group. (CPP=coronary perfusion pressure.). The Annals of Thoracic Surgery 1997 64, 1250-1255DOI: (10.1016/S0003-4975(97)00907-7) Copyright © 1997 The Society of Thoracic Surgeons Terms and Conditions