Determination of right ventricular volumes during aortic surgery

J Cardiothorac Anesth. 1989 Jun;3(3):280-5. doi: 10.1016/0888-6296(89)90108-7.

Abstract

The aim of the present study was to evaluate right ventricular (RV) preload by measurements of right ventricular volumes during aortic clamping and unclamping. Nine patients (aged 67 +/- 9 years) undergoing infrarenal aortic aneurysmectomy were monitored with a pulmonary artery catheter equipped with a fast-response thermistor, allowing determination of RV volumes by the thermodilution technique. Anesthesia consisted of a continuous infusion of alfentanil and 50% N2O. Aortic clamping resulted in a significant decrease in cardiac index (CI) and a significant increase in systemic vascular resistance (SVR). There was no significant change in right ventricular ejection fraction (RVEF) (from 35% +/- 6% to 33% +/- 8%) in the presence of a significant decrease in stroke index (from 37.2 +/- 9.8 to 31.1 +/- 10.0 mL/beat/m2, P less than 0.05), indicating a significant decrease in RV end-diastolic volume (from 106 +/- 17 to 92 +/- 19 mL, P less than 0.01). There were no significant changes in cardiac filling pressures. Aortic unclamping was associated with a significant increase in CI and a significant decrease in SVR. There were no significant changes in cardiac filling pressures, RVEF, or RV volumes. Measurements of RV volumes indicated that aortic clamping resulted in a decrease in RV preload, which is usually not demonstrated by measurements of right atrial pressure alone.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aorta / surgery*
  • Aortic Aneurysm / surgery
  • Blood Pressure / physiology
  • Cardiac Output / physiology
  • Cardiac Volume / physiology*
  • Constriction
  • Female
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Pulmonary Artery
  • Stroke Volume / physiology
  • Vascular Resistance / physiology
  • Ventricular Function, Right / physiology*