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Therapeutic implications of intraoperative pressure measurements after the Fontan operation.
Knott-Craig, C J; Schaff, H V; Puga, F J; Julsrud, P R; Gehring, D G; Danielson, G K.
Afiliación
  • Knott-Craig CJ; Division of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905.
Ann Thorac Surg ; 57(4): 937-9; discussion 939-40, 1994 Apr.
Article en En | MEDLINE | ID: mdl-8166545
Central venous pressure (CVP) and left atrial pressure (LAP) were monitored continuously for the first 72 hours postoperatively in 32 patients who underwent a Fontan operation in whom preoperative measurements of the pulmonary artery index were available. Integrated mean values were generated for each patient for the following time frames: (1) the first 12 hours after operation, (2) the first 24 hours after operation, (3) postoperative day 2, and (4) postoperative day 3. We found no difference in the CVP, LAP, or transpulmonary gradient, derived as CVP-LAP, measured in the operating room at the completion of the operation versus that measured on the third postoperative day: CVP, 18 +/- 2 mmHg versus 19 +/- 3 mmHg; LAP, 10 +/- 2 mmHg versus 10 +/- 3 mmHg; and transpulmonary gradient, 8 +/- 2 mmHg versus 8 +/- 2 mmHg. The combined incidence of hospital mortality and postoperative takedown associated with the Fontan repair was 12.5%. These findings suggest that a poor hemodynamic result from the Fontan operation can be predicted from intraoperative pressure measurements, because the CVP, LAP, and transpulmonary gradient are unlikely to change significantly in the early postoperative period. Therefore, a decision to take down or fenestrate the repair can reasonably be made in the operating room or the early postoperative period.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Posoperatorios / Determinación de la Presión Sanguínea / Presión Venosa Central / Función Atrial / Monitoreo Intraoperatorio / Cardiopatías Congénitas Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Ann Thorac Surg Año: 1994 Tipo del documento: Article Pais de publicación: Países Bajos
Buscar en Google
Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Posoperatorios / Determinación de la Presión Sanguínea / Presión Venosa Central / Función Atrial / Monitoreo Intraoperatorio / Cardiopatías Congénitas Tipo de estudio: Diagnostic_studies / Etiology_studies / Evaluation_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Ann Thorac Surg Año: 1994 Tipo del documento: Article Pais de publicación: Países Bajos