[Monitoring myocardial performance after open heart surgery by calculation of diastolic and systolic pressure time index (author's transl)].

Abstract

In order to determine the incidence of subendocardial ischemia after open heart surgery, subendocardial blood flow was monitored in 171 patients subjected to mitral and/or aortic valve replacement or coronary revascularization by on-line calculation of Diastolic (DPTI) and Systolic Pressure Time Index (TTI). Body hypothermia with an esophageal temperature of 25 degrees C and magnesium-aspartate-procaine cardioplegia were applied for myocardial protection. Ten patients developed low cardiac output state with two early deaths. In the two patients with fatal low cardiac output DPTI/TTI remained below 0.8. In the remaining 8 patients DPTI/TTI rose to 1.4 after a mean recovery time of 36 hours. In 161 patients (94%) no low cardiac output state evolved and DPTI/TTI rose to 1.3 within 60 min. after termination of cardiopulmonary bypass. Our results indicate that body hypothermia of 25 degrees C combined with magnesium-aspartate-procaine cardioplegia can reduce the incidence of subendocardial ischemia, but does not prevent this complication completely after anoxic times beyond 60-70 minutes.

• Authors: W Seybold-Epting, G Fenchel, R Stunkat, H Seboldt, H E Hoffmeister
• Journal: Thoraxchirurgie, vaskulare Chirurgie (Thoraxchir Vask Chir) Vol. 26 Issue 5 Pg. 348-52 (Oct 1978) ISSN: 0040-6384 [Print] Germany
• Vernacular Title: Uberwachung der Myokardfunktion nach offenen Herzoperationen durch Messung des diastolischen und systolischen Druck-Zeit-Index.
• PMID: 715754 (Publication Type: English Abstract, Journal Article)

Topics

• Blood Pressure
• Cardiac Output
• Cardiac Surgical Procedures (adverse effects)
• Coronary Disease (surgery)
• Heart Arrest, Induced (methods)
• Heart Valve Diseases (surgery)
• Humans
• Monitoring, Physiologic
• Postoperative Care
• Shock, Cardiogenic (etiology, prevention & control)