Cardiac hemodynamics immediately following aortic valve surgery

Abstract

Comments and summary There have been a few reports concerning hemodynamic studies following cardiac surgery. 6, 7, 8 The present study describes a method of obtaining serial hemodynamic profiles on postoperative cardiac patients and presents data from a group of patients with isolated acquired aortic valve disease. Perhaps the most striking finding in this study is that the average patient following Starr-Edwards valve replacement for acquired aortic valvular disease demonstrated essentially normal hemodynamics, despite the fact that all of the patients had been limited by their heart disease preoperatively. Even patients with decreased cardiac indices preoperatively, unless they also had marked left ventricular failure, promptly returned to normal in the postoperative period. Patients with preoperative evidence of marked left ventricular failure, however, and also patients who immediately postoperatively evidenced reduced cardiac indices did not do so well. Many of them evidenced continued low cardiac indices, low systemic blood pressures, and left ventricular failure; all three of the hospital deaths were in this group. There was very little difference following Starr-Edwards valve replacement in patients with predominant aortic stenosis and those with predominant aortic regurgitation. The postoperative hemodynamic data also indicated that coronary perfusion was superior to myocardial hypothermia in its protective effects on the heart and the consequent myocardial performance in the early postoperative period. From the data presented here, there did not seem to be any significant difference between left coronary perfusion and bilateral coronary perfusion.