Introduction: Pulmonary regurgitation (PR) is a major concern after right ventricular (RV) outflow tract surgery. We assessed the impact of physiological changes in pulmonary vasculature on hemodynamic severity of PR and RV function and their potential clinical implications for postoperative management using a porcine model with severe PR.
Materials And Methods: Eight porcine models of acute PR were established by means of resection of pulmonary valve on cardiopulmonary bypass. After separation from bypass and stabilization, blood flow in the main pulmonary artery was measured by a pulsed Doppler flowmeter, and RV systolic function was assessed on the basis of RV segment shortening (RVSS), which was analyzed by sonomicrometry. In the acute PR model, we verified the impact of pulmonary vascular resistance (Rp) on pulmonary regurgitant fraction (PRF) and RV function. Pulmonary vascular resistance was changed by manipulating the level of PaCo 2 and by inhalation of nitric oxide (NO).
Results: After bypass, the mean PRF was 40% ± 5%, and there was a deterioration of RV function. Under each ventilation condition (high CO2, low CO2, and NO 20 ppm), Rp was 836 ± 207 dyne × s × cm(-5), 499 ± 125 dyne × s × cm(-5), and 340 ± 102 dyne × s × cm(-5), respectively, and PRF was 60% ± 10%, 37% ± 5%, and 24% ± 4%, respectively, under each condition. They also showed a positive correlation in all animals. Cardiac output and RVSS were decreased by hypercapnia, while they were significantly improved after NO inhalation.
Conclusions: This study indicates that low Rp after right ventricular outflow tract reconstruction (RVOTR) resulting in acute PR is advantageous in reducing the severity of PR and RV volume load. These findings may have clinical implications for early and long-term postoperative management of patients subjected to RVOTR with resulting pulmonary valve incompetence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/2150135115598209 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictors of the Need for Permanent Pacemaker Implantation After Surgical Aortic Valve Replacement with a Biological Prosthesis and the Effect on Long-Term Survival.
J Cardiovasc Dev Dis
December 2024
Faculty of Medicine & Health Sciences, University of Antwerp, 2610 Antwerp, Belgium.
The need for a permanent pacemaker (PPM) implantation after surgical aortic valve implantation (SAVR) is a recognized postoperative complication, with potentially long-term reduced survival. From 1987 to 2017, 2500 consecutive patients underwent SAVR with a biological valve with or without concomitant procedures such as CABG or mitral valve repair. Mechanical valves or valves in another position were excluded.
View Article and Find Full Text PDFThe Number of Remaining Teeth-A Predictability Factor for a Certain Type of Cardiovascular Condition in a Group of Hospitalized Individuals.
J Pers Med
December 2024
Department of Prosthodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
The aim of this study was to determine whether the oral parameter reflecting the total number of remaining permanent teeth (NRT) on both arches represents a predictability factor for a certain type of cardiovascular condition. : This study included 84 subjects (40 males and 44 females) with ages between 50 and 89 years old, hospitalized in the Cardiology Department, who required dental examinations and specialized therapeutic interventions within the Emergency Dental Department of the same medical facility. : The study participant's data were statically analyzed.
View Article and Find Full Text PDFClinical Impact of Admission Day on Outcomes in Acutely Decompensated Aortic Stenosis: A Nationwide Analysis.
J Pers Med
November 2024
Department of Pulmonary and Critical Care Medicine, The University of Toledo, Toledo, OH 43606, USA.
Aortic stenosis (AS) is a critical valvular heart disease associated with significant morbidity and mortality if not managed promptly. Previous studies have highlighted the "weekend effect", where the day of admission impacts outcomes in various cardiac conditions. This study evaluates the impact of weekend versus weekday admissions on outcomes in patients admitted with acutely decompensated aortic stenosis.
View Article and Find Full Text PDFECMO in the Management of Noncardiogenic Pulmonary Edema with Increased Inflammatory Reaction After Cardiac Surgery: A Case Report and Literature Review.
Diseases
December 2024
Department of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process.
View Article and Find Full Text PDFExtended Rhythm Monitoring to Assess for Ventricular Arrhythmias After Transcatheter Pulmonary Valve Replacement With the Harmony Valve.
Circ Cardiovasc Interv
December 2024
Department of Pediatrics, Pediatric Cardiology, Stanford University, Palo Alto, CA. (J.K.Y., L.W., A.C.T., H.C., A.W.R., L.F.P., S.R.C., A.M.D., D.B.M.).
Background: Varying rates of nonsustained ventricular tachycardia (NSVT) have been reported early after transcatheter pulmonary valve replacement (TPVR) with the Harmony valve, but data regarding rhythm outcomes beyond hospital discharge are limited. This study aims to characterize ventricular arrhythmias after Harmony TPVR from implant through mid-term follow-up.
Methods: Ventricular arrhythmia data from postimplant telemetry and follow-up extended rhythm monitoring (ERM) were analyzed after Harmony TPVR.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!