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폐동맥 고혈압과 우심실 부전이 동반된 만성 승모판막 질환 환자에서 승모판막 대치술이 수술 직후 우심실 기능에 미치는 영향

Other Titles
 The Effect of Preoperative Pulmonary Arterial Pressure and Right Ventricular Function on the Changes in Right Ventricular Function after Mitral Valve Replacement 
 강상화  ;  곽영란  ;  심연희  ;  오영준  ;  남상범  ;  박준희  ;  홍용우 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.40(1) : 16-21, 2001 
Journal Title
 Journal of Korean Society of Anesthesiologist (대한마취과학회지) 
Issue Date
blood pressure ; hypertension ; heart ; pulmonary ; hemodynamics ; right ventricular ejection fraction ; surgery ; mitral valve replacement
Background: In patients with mitral valvular disease with pulmonary hypertension (PHT) accompanying right ventricular (RV) dysfunction, mitral valve replacement (MVR) improves RV function and other hemodynamic variables in long term follow-up. However, there are controversies in improvement of RV function in the immediate postoperative period. We compared the RV function immediately after a MVR with a pulmonary artery catheter (PAC) between patients with normal and decreased RV function with PHT preoperatively. Methods: Twenty nine patients undergoing a MVR were included in the study. The patients (n = 14) with mean pulmonary arterial pressure (PAP) ≤ 25 mmHg were assigned to group I and the patients (n = 15) with mean PAP ⁡ 25 mmHg were assigned to group II. A PAC with rapid response-thermistors which enables us to determine right ventricular ejection fraction (RVEF) was inserted in all patients and hemodynamic variables were measured before and after cardiopulmonary bypass (CPB). Results: After CPB, PAP, pulmonary vascular resistance index (PVRI), and RV end-diastolc volume (RVEDV) were significantly decreased and RVEF was significantly increased in group II compared with group I in which no hemodynamic variables were changed. Conclusions: A MVR decreased RV afterload and increased RV function more significantly in patients with preoperative PHT accompanying RV dysfunction than in patients with normal PAP preoperatively.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
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