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폐동맥 고혈압을 동반한 심방실 중격 결손증과 승모판막증환자에서의 수술 전후 폐혈역학적 비교

Other Titles
 Pulmonary Hemodynamics in Patients with Pulmonary Hypertension Undergoing Repair of Atrial or Ventricular Septal Defect and Mitral Valve Replacement 
 임현교  ;  이광호  ;  곽노길  ;  이춘수  ;  유은숙  ;  곽영란  ;  방서욱  ;  홍용우 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.32(1) : 116-121, 1997 
Journal Title
 Journal of Korean Society of Anesthesiologist (대한마취과학회지) 
Issue Date
Blood pressure pulmonary hypertension ; Surgery cardiac ; Heart cardiopulmonary bypass ; Monitoring pulmonary hemodynamics
BACKGROUND The mechanisms of pulmonary hypertension(PHT) are usually quite different in acquired disorders of the left side of the heart from those of congenital heart disease. Accordingly, this study was designed to compare pulmonary hemodynamics immediately after cardiopulmonary bypass(CPB) in patients with undergoing repair of atrial(ASD) or ventricular septal defect(VSD) and mitral valve replacement(MVR). METHODS 49 patients with PHT defined as a resting systolic pulmonary arterial pressure(SPAP) greater than 35 mmHg were studied and were divided preoperatively into two groups; repair of ASD or VSD(Group I, n=18) and MVR(Group II, n=31). Measurements were made after sternotomy and prior to initiation of CPB and upon stabilization following discontinuation of CPB. RESULTS In group I, SPAP, DPAP and MPAP decreased by 44%, 22% and 35% respectively and pulmonary vascular resistance index(PVRI) decreased by 47% after CPB. In group II, SPAP, DPAP and MPAP revealed 25%, 32% and 29% reduction respectively and PVRI decrease by 39% after CPB. SPAP decreased more significantly after CPB in group I(44% vs 25%, p<0.05). CI increased significantly in group II while decreased in group I. Intraoperative inotropes and vasodilators were used more in group II than in group I(24/31 vs 6/18). CONCLUSIONS The successful replacement of the valve and patch repair of defect may reduce both PAP and PVRI moderately in patients with PHT.
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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
Hong, Yong Woo(홍용우)
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