Japanese
Title体外循環前後における左心機能および右心機能の変化―経食道心エコーと右室駆出率測定用スワンガンツカテーテル併用の有用性―
Subtitle原著
Authors近藤泉, 野村実, 吉田啓子, 長沢千奈美, 杉野芳美, 内田桂子, 芦刈英理, 岩出宗代, 白井希明, 藤田昌雄, 鈴木英弘
Authors(kana)
Organization東京女子医科大学麻酔学教室
Journal循環制御
Volume14
Number1
Page51-56
Year/Month1993/
Article原著
Publisher日本循環制御医学会
Abstract「要旨」僧帽弁疾患および冠動脈疾患患者の開心術において, 経食道エコーと右室駆出率スワンガンツカテーテルの併用により術中心機能評価を行なった. 体外循環前後を比較すると, 僧帽弁疾患では, 体外循環後に, 左室駆出率や左室拡張末期容積に有意な変化なく, 平均肺動脈圧, 右室拡張末期容積は有意に低下し, 右室駆出率, 心係数は有意に増加した. つまり, 僧帽弁置換術後は, 左心機能は維持され, 右心機能が有意に改善された. 一方, 冠動脈疾患では, 体外循環後, 左室駆出率は変化なく, 左室拡張末期容積に軽度の増加を示した. 右室駆出率, 心係数, 右室拡張末期容積には, 有意な変化はなかった. 冠動脈再建術後は, 軽度の左心機能の抑制がみられたが, 右心機能は維持された.
Practice基礎医学・関連科学
Keywordsright ventriculer ejection fraction, left ventriculer ejection fraction, intraopgrative monitoring, cardiac surgery
English
TitleEstimation of Biventricular Hemodynamic Functions using -a Pulumonary Artery Catheter with a Rapid Response Thermistor and Transesophageal Echocardiography during Cardiac Surgery-
Subtitle
AuthorsIzumi Kondo, Minoru Nomura, Keiko Yoshida, Chinami Nagasawa, Yosimi Sugino, Keiko Utida, Eri Ashikari, Motoyo Iwade, Kimei Shirai, Masao Fujita, Hidehiro Suzuki
Authors(kana)
OrganizationDepartment of Anesthesiology,Tokyo Women's Medical College
JournalCirculation Control
Volume14
Number1
Page51-56
Year/Month1993/
ArticleOriginal article
PublisherJapan Society of Circulation Control
AbstractThe right ventricular ejection fraction (RVEF) and the left ventricular ejection fraction (LVEF) were measured to examine biventricular hemodynamic functions during cardiac surgery, and each patient was divided into the two groups: the coronary artery disease group (CABG) and the mitral valve disease group (MVR). Newly developed pulmonary artery catheters with a rapid response thermistor (REF-1: model 93A-431H-7.5F, the Baxter Company) were used to measure the RVEF, and transesophageal echocardiography (TEE) to measure the LVEF at mid-papillary levels by Pombo method. The hemodynamic values of each group were measured before induction of anesthesia (T1), after induction, after intubation (T2), after incision, after sternotomy, after the CPB at 30 minutes (T3) and at 60 minutes. In the MVR group, the RVEF significantly increased, from 25.9±9.2% (T1) to 34.4±6.0% (T3). Also, a significant increase was noted in the cardiac index (Cl), from 2.6±0.5 L/min/m2 to 3.6±0.6 L/min/m2. The LVEF, however, decreased from 61.3±13.1% (T2) to 54.4±13.6% (T3). The MPAP also significant-ly decreased, from 27.0±14.6 mmHg to 16.9±3.8 mmHg, as did the RVEDV (right ventricular end-diastoric volume), from 232±81 ml to 178±21 ml and the LVEDV (left ventricular end-diastoric volume) from 192±110 ml to 133±87 ml. In the CABG group the RVEF increased, from 47.4±8.7% (T1) to 49.5±10.8% (T3) and the LVEF from 64.6±11.5% (T2) to 66.6±16.4% (T3). Futher, the RVEDV decreased from 152±40 ml to 146±33 ml, on the other hand Cl increased from 3.2±1.2 ml/min/m2 to 4.0±0.5 ml/min/m2, and the LVEDV from 89±47 ml to 143±148 ml. We concluded that the LVEF decreased slightly and RVEF remained unchanged in the CABG group, but in the MVR group, LVEF remained unchanged and RVEF improved after the CPB significantly, due to the reduction of the pulmonary vascular reistance as a result of valve replacement. The combination of REF-1 catheter and TEE provide an useful information of biventricular function during cardiac surgery.
PracticeBasic medicine
Keywordsright ventriculer ejection fraction, left ventriculer ejection fraction, intraopgrative monitoring, cardiac surgery

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