Abstract
Objective: Postoperative cardiac depression is attributed to ischemia and the effects of cardiopulmonary
bypass (CPB). To evaluate the effect of CPB alone on postoperative left ventricular
(LV) dysfunction, we used a conductance catheter to determine the LV performance by
pressure-volume relation before and after CPB. Methods: Twenty-two 3-week-old piglets underwent sternotomy and normothermic CPB for one hour.
A conductance catheter was placed in the LV cavity. End-systolic pressure-volume relationships
(ESPVR), left ventricular end-diastolic pressure (LVEDP) and systemic vascular resistance
(SVR) were measured under steady-state conditions before and 15 min after weaning
from CPB in group A (n = 11). Group B included 11 piglets without CPB and served as
control. Results: There was no difference between groups before initiating CPB. As an indication of
depressed LV function, the ESPVR slope (mmHg/ml) was significantly lower in group
A after weaning from CPB than in group B (1.69 ± 0.5 vs. 1.86 ± 0.55; p = 0.008).
In group A, peak dP/dtmax index (mmHg/s/m2) decreased markedly (1596 ± 339 vs. 2045 ± 206; p = 0.03), while LVEDP (mmHg) was
significantly increased (11.7 ± 2.6 vs. 5.4 ± 0.9; p < 0.0001). In addition, SVRindex (dyn x s x cm-5/m2) in group A was significantly lower (1407 ± 176 vs. 1677 ± 313; p < 0.0001) than
in group B. Conclusion: Using the very sensitive conductance catheter technique in a pig model, we could
show that CPB leads to a significant depression of LV contractility and elastance
even without ischemic arrest.
Key words
Cardiopulmonary bypass - conductance catheter - left ventricular function - myocardial
contractility
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Tayfun Aybek, MD
Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University
Theodor Stern Kai 7
60590 Frankfurt, Germany
Phone: +49 (69) 6301-6141
Fax: +49 (69) 6301-83279
Email: T.Aybek@em.uni-frankfurt.de
