Coronary Surgery Clinical Trial
Official title:
Evaluation of Hemodynamic Changes of the Left Ventricle Following the Use of Extracorporeal Circulation
The interpretation of perioperative measures of cardiac function during cardiac surgery is
complicated. In particular, the evaluation of the diastolic compliance of the left ventricle.
In addition, they are subject to variations induced by post-charge changes caused by the
anesthesia, extracorporeal circulation (ECC) and the surgical procedure itself.
Left ventricular failure is frequently measured by alteration of LV contractile properties,
and very rarely by alteration of LV compliance. However, both contractility (systolic) and
relaxation (diastolic) parameters are important for the left ventricle to perform its
function adequately. Left ventricular failure after cardiac surgery with extracorporeal
circulation and cardiac arrest under cardioplegia protection is an important and frequently
reported complication. The investigator's objectives are to characterize the diastolic
hemodynamic mechanisms of this left ventricular failure and to identify predictors of this
failure in the postoperative period.
The quantification of the systolic and diastolic functions of the left ventricle by
ventricular pressure-volume curves is the technique of reference today, because it allows to
determine parameters that are independent of the pre- and post-load conditions. Previous
studies using the conductance catheter for the purpose of estimating left ventricular
function perioperatively are rare and report conflicting results. In addition, they were
mainly intended to measure the systolic function of the left ventricle. Only one reported the
diastolic relaxation parameters evaluated by a conductance catheter. This study showed
immediately after withdrawal of the extracorporeal circulation a significant alteration of
the diastolic relaxation of the left ventricle, but was not interested in its early (kinetic)
evolution peroperatively.
The investigator's experience shows that, in the quarter-hour following the weaning of the
extracorporeal circulation, a decrease in filling pressures of the left ventricle concomitant
with an increase in cardiac output is objectified. These observations are consistent with a
significant improvement in left ventricle compliance, but have never been reported.
The objectives of this study are:
- To characterize the left ventricular diastolic failure after withdrawal of the
extracorporeal circulation in coronary surgery.
- To identify the kinetics of this early diastolic failure after withdrawal of the
extracorporeal circulation.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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N/A |