Document Detail


Acute diastolic dysfunction in thoracoabdominal aortic aneurysm surgery.
MedLine Citation:
PMID:  16434758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report transesophageal echocardiographic (TEE) findings consistent with intraoperative acute diastolic dysfunction in a series of patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair. METHODS: A series of nine consecutive patients underwent TAAA repair with intraoperative TEE monitoring. Surgical repair was performed with the adjunct of a left atrio-femoral bypass. Invasive arterial and venous pressures were monitored. Intraoperative TEE was utilized to assess the diastolic function before, and during aortic cross clamping. Diastolic dysfunction was defined as a mitral inflow pulsed wave Doppler (E: A ratio) < 1. RESULTS: All patients demonstrated an E: A ratio > 1 (1.3 +/- 0.08) before aortic cross clamping. During cross clamp, the E: A ratio decreased to < 1 (0.75 +/- 0.05) in six of nine patients consistent with diastolic dysfunction. The three patients who did not develop E: A changes were receiving ss-blockers pre-operatively. Patients with diastolic dysfunction were treated with nitroglycerin infusions, which resulted in restoration of their E: A ratios > 1 (1.2 +/- 0.09). Three of the patients with intraoperative diastolic dysfunction developed postoperative myocardial infarction. CONCLUSIONS: Chronic diastolic dysfunction is a well-known entity. This report describes acute diastolic dysfunction, which was observed frequently in patients undergoing TAAA during aortic cross clamp. Further research is required to confirm this phenomenon and determine its possible association with increased postoperative cardiac morbidity.
Authors:
Ashraf Fayad; Homer Yang; Howard Nathan; Gregory L Bryson; Claudio S Cina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  53     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-25     Completed Date:  2006-06-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  168-73     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, University of Ottawa, B309, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada. afayad@ottawahospital.on.ca
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aorta / physiology
Aortic Aneurysm / surgery*
Constriction
Diastole
Echocardiography, Transesophageal
Female
Hemodynamics
Humans
Intraoperative Complications / ultrasonography*
Male
Middle Aged
Monitoring, Intraoperative
Ventricular Dysfunction, Left / etiology*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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