Pre- and Postoperative Hemodynamic Assessments and Survival Rates in Patients with Postinfarction Ventricular Septal Perforation : The Effectiveness and Limitations of Coronary Care Unit
スポンサーリンク
概要
- 論文の詳細を見る
Pre- and postoperative hemodynamics were assessed in 14 consecutive patients who developed ventricular septal perforation (VSP) following acute myocardial infarction (AMI). Results were correlated with the surgical outcome and with postoperative clinical improvements. The patients were divided into 3 groups according to the time intervals between the onset of AMI and the operation; acute (within 2 weeks after AMI), subacute (between 2 and 4 weeks) and chronic (after 4 weeks). In the above groups, 6, 2, and 6 patients were included, respectively. Eleven patients had anteroseptal infarction and 3 patients sustained inferior infarction. The survival rates were 33, 50 and 100% in the acute, subacute and chronic groups, respectively with an overall survival rate of 64%. Hemodynamic comparisons between survivors and non-survivors revealed that the systolic aortic pressure and left ventricular stroke volume index were significantly higher and the right ventricular end-diastolic pressure was significantly lower in survivors than in non-survivors (p<0.05). although no statistical significance was obtained, left ventricular end-diastolic volumes and ejection fractions were higher in survivors. No difference was present between survivors and non-survivors in either Qp/Qs, Pp/Ps, Rp/Rs, systolic pulmonary pressure, left ventricular end-diastolic pressure or cardiac index. Patients with low arterial pressure and high right ventricular end-diastolic pressure under intensive medical regimens, indicating the presence of cardiogenic, shock and/or associated right ventricular infarction or severe failure, had a high mortality and should be considered for emergency operation. Postoperative hemodynamics improved significantly in all variables measured (p<0.05-0.01). Patients with a VSP should all be considered for surgery unless a definite contraindication exists.
- 社団法人日本循環器学会の論文
- 1984-07-20
著者
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KITAMURA Soichiro
Department of Cardiovascular Surgery, National Cardiovascular Center
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Suyama Kazuhiro
国立循環器病センター 心臓血管内科
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Miyagi Yasuo
Department Of Surgery 2 Nippon Medical School
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Miyagi Yasuo
Department Of Surgery Iii Nara Medical College
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Shirao Kuniaki
National Cardiovascular Center
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Kitamura Soichiro
国立循環器病センター 心臓血管外科
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Kitamura Soichiro
循環器セ
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Kawashima Yasunaru
Department of Cardivasucular Surgery, National Cardiovascular Center
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KAWACHI Kanji
Department of Cardiovascular Surgery, Ehime University Hospital
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Kitamura Soichiro
Department Of Cardiovascular Surgery National Cardiovascular Center
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Kawachi Kanji
Department Of Surgery Ii Ehime University School Of Medicine
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Kawachi Kanji
Department Of Cardiovascular Surgery Ehime University Hospital
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Kitamura S
Department Of Surgery Osaka University Hospital And Nara Medical College Hospital
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MORITA RYUICHI
Department of Surgery III, Nara Medical College
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OYAMA CHOKEN
Department of Surgery III, Nara Medical College
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Miyagi Yasuo
Department Of Biological Regulation And Regenerative Surgery Nippon Medical School Graduate School O
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YAMADA YOSHIKI
Department of Surgery III, Nara Medical College
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KIM KEITAKU
Department of Surgery III, Nara Medical College
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NISHII TSUTOMU
Department of Surgery III, Nara Medical College
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Kitamura Soichiro
3rd Department Of Surgery Nara Medical College
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Kitamura Soichiro
Department Of Cardiology National Cardiovascular Center
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Ketaku Kim
Department Of Surgery Iii Nara Medical Collge
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Kim Keitaku
Department Of Internal Medicine Mimihara General Hospital
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Oyama Choken
Department Of Surgery Iii Nara Medical College
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Oyama Choken
1st Department Of Surgery Osaka University Medical School
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Nishii Tsutomu
Department Of Surgery Iii Nara Medical College
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Yamada Yoshiki
Department Of Surgery Iii Nara Medical College
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Morita Rhuichi
Department Of Surgery Iii Nara Medical College
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Kitamura Soichiro
Department Of Surgery Iii Nara Medical College
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Oyama Choken
Department Of Surgery Iii Nara Medical Collge
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Kitamura Soichiro
Department Of Physiology Ii Nara Medical University
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Ohyama Choken
1st Dept. Of Surg. Osaka Univ. School Of Med.
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Ohyama Choken
1st Dept. Of Surgery Osaka Univ. School Of Med
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Kawachi Kanji
Department Of Organ Regenerative Surgery Ehime University Graduate School Of Medicine
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Ohoyama Choken
1st Dept. Of Surg. Osaka Univ. School Of Med.
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Kitamura Soichiro
1st Dept Of Surgery Osaka University
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Kawamura Shinji
1st Department Of Surgery Medical School Osaka Univ.
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Kawamura Shinji
1st Dept. Of Med. Osaka Univ. Med. School
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KAWASHIMA Yasunaru
Department of Cardiovascular Surgery, National Cardiovascular Center
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