Prediction of Surgical Result of Valve Replacement for Chronic Isolated Mitral Regurgitation : The significance of preoperative estimation of postoperative left ventricular afterload : CLINICAL EVALUATION OF CARDIAC PERFORMANCE
スポンサーリンク
概要
- 論文の詳細を見る
Left ventricular (LV) afterload increases after mitral valve replacement, thus it would be useful to estimate postoperative LV afterload before surgery. We tested the usefulness of an index, wall stress, obtained from preoperative end-diastolic LV dimensions and diastolic blood pressure which would represent LV afterload after surgery. The data were compared with surgical mortality and morbidity. The wall stress ranged from 98 to 220 kdynes/cm^2 and was 202 or higher in 3 patients who died. Five patients had wall stress above 200 kdynes/cm^2. Among these, intra-aortic balloon pumping (IABP) was used in 4, and 3 died. Prolonged catecholamine support for >10 days was given to all of the 4 patients, including two who died 14 and 23 days after surgery. Among 38 patients who had wall stress less than 200 kdynes/cm^2, none died, IABP was performed in 3 patients, and prolonged catecholamine infusion was required in 5 patients. The incidence of mortality and morbidity were significantly higher in the high stress than in the low stress group (Chi-square analysis). Left ventricular end-diastolic index was larger in the high stress than in the low stress group (p<0.05). The mass/end-diastolic volume ratio was smaller in the high stress group than in the low stress group (P<0.05). In conclusion, this new index, predictive wall stress, is useful in selecting patients who would have high mortality and morbidity.
- 社団法人日本循環器学会の論文
- 1992-07-20
著者
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Momma Kazuo
Department Of Pediatric Cardiology The Heart Institute Tokyo Women's Med. Coll.
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Nakazawa Makoto
Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Womens Medical University
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Momma Kazuo
Department Of Pediatric Cardiology
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Oyama Kotaro
Department Of Pediatrics Iwate Medical University
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Oyama Kotaro
Department Of Pediatric Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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YASUKOUCHI Satoshi
Department of Pediatric Cardiology, Nagano Prefectural Children's Hospital
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SEGUCHI Masashi
Department of Pediatrics, Seirei Hamamatsu General Hospital
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Momma Kazuo
Department Of Pediatric Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Seguchi Masashi
Department Of Pediatric Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Seguchi Masashi
Department Of Cardiovascular Surgery And Department Of Pediatrics Seirei Hamamatsu General Hospital
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Yasukouchi Satoshi
Department Of Pediatric Cardiology Nagano Prefectural Children's Hospital
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Yasukouchi Satoshi
Department Of Pediatric Cardiology The Heart Institute Of Japan Tokyo Women's Medical College
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Nakazawa Makoto
Department Of Pediatric Cardiology Heart Institute Tokyo Women's Medical University
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Nakazawa Makoto
Department Of Pediatric Cardiology Heart Institute Of Japan Tokyo Women's Medical College
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Oyama Kotaro
Department Of Pediatric Cardiology Iwate Medical University Memorial Heart Center
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MOMMA KAZUO
Department of Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical College
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NAKAZAWA MAKOTO
Department of Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical College
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