GK News 2 - шаблон joomla Видео

Banner1

Log in
Powered by Spearhead Software Labs Joomla Facebook Like Button
05 March 2014
The contemporary tendency for increase of prophylactic surgical procedures as part of the sophisticated treatment of breast cancer is the foundation for the present study. Evaluation of risk

PERSISTENT COMPROMISED HEMODYNAMIC FUNCTION, DUE TO SINGLE VENTRICULAR EPICARDIAL PACING, AFTER AORTIC VALVE REPLACEMENT SURGERY: A CASE REPORT

Konstantinos Giakoumidakis1, Christos Charitos2

1) Cardiac Surgery Intensive Care Unit, “Evangelismos” General Hospital of Athens, Athens, Greece.

2) Cardiothoracic Surgery Department, “Evangelismos” General Hospital of Athens, Athens, Greece.

Disclosure: The author has declared no conflicts of interest.

Received: 03.08.16 Accepted: 18.08.16

Citation: 10.5455/ijsm.aortic-valve-replacement-surgery

Fulltext PDF Download

Cite/Export: EndNote/RefWorks

altmetric journalmedica

Abstract:

We report the case of a 69-year-old woman, who was admitted to the cardiac surgery intensive care unit (ICU) of a tertiary hospital, after surgical aortic valve replacement, due to severe aortic stenosis. During the early postoperative period, the patient was hemodynamically stable and her cardiac rhythm was supported by temporary epicardial ventricular pacing. One hour after her ICU admission, the woman presented compromised hemodynamics, characterized by severe hypotension with poor response to aggressive inotropic, vasopressor and fluid therapy. After 15 minutes of her significant clinical worsening, the change of the pacing mode from single ventricular to single atrial effected immediate hemodynamic stabilization, improved arterial blood pressure and optimum patient cardiovascular function. This could be explained by the significantly reduced cardiac output in the absence of atrial contraction to assist ventricular preloading, which characterized some patients with impaired ventricular function, as those with severe aortic stenosis.

Keywords: Aortic valve replacement, Aortic valve stenosis, Atrial pacing, Epicardial pacing, Postoperative care.


REFERENCES:

1. Bojar BM. Manual of perioperative care in adult cardiac surgery. 5th edn. Wiley – Blackwell, 2011.
2. Reade MC. Temporary epicardial pacing after cardiac surgery: a practical review: part 1: general considerations
in the management of epicardial pacing. Anaesthesia 2007; 62:264-271.
3. Hurlé A, Gómez-Plana J, Sánchez J, Martínez JG, Meseguer J, Llamas P. Optimal location for temporary epicardial pacing
leads following open heart surgery. Pacing Clin Electrophysiol 2002; 25:1049-1052.
4. Reade MC. Temporary epicardial pacing after cardiac surgery: a practical review. Part 2: Selection of epicardial
pacing modes and troubleshooting. Anaesthesia 2007; 62:364-373.
5. Curtis JJ, Maloney JD, Barnhorst DA, Pluth JR, Hartzler GO,
Wallace RB. A critical look at temporary ventricular pacing following cardiac surgery. Surgery 1977; 82:888-893.
6. Curtis J, Walls J, Boley T, Reid J, Flaker G, Madigan N, et al. Influence of atrioventricular synchrony on hemodynamics
in patients with normal and low ejection fractions following open heart surgery. Am Surg 1986; 52:93-96.
7. Broka SM, Ducart AR, Collard EL, Eucher PM, Jamart J, Delire VR, et al. Hemodynamic benefit of optimizing atrioventricular
delay after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1997; 11:723-728.
8. Dzemali O, Bakhtiary F, Israel CW, Ackermann H, Moritz A, Kleine P. Impact of different pacing modes on left ventricular function following cardiopulmonary bypass. Thorac Cardiovasc Surg 2008; 56:87-92.
9. Muehlschlegel JD, Peng YG, Lobato EB, Hess PJ Jr, Martin TD, Klodell CT Jr. Temporary biventricular pacing postcardiopulmonary bypass in patients with reduced ejection fraction. J Card Surg 2008; 23:324-330.
10. Vaughan P, Bhatti F, Hunter S, Dunning J. Does biventricular pacing provide a superior cardiac output compared to
univentricular pacing wires after cardiac surgery? Interact Cardiovasc Thorac Surg 2009; 8:673-678.


How to Cite this Article

Giakoumidakis, K. and Charitos, C. (2017). PERSISTENT COMPROMISED HEMODYNAMIC FUNCTION, DUE TO SINGLE VENTRICULAR EPICARDIAL PACING, AFTER AORTIC VALVE REPLACEMENT SURGERY: A CASE REPORT. International Journal of Surgery and Medicine, [online] 3(3). Available at: http://10.5455/ijsm.aortic-valve-replacement-surgery [Accessed 18 Mar. 2017].

Last modified onSaturday, 28 July 2018 20:17

Leave a comment

Make sure you enter the (*) required information where indicated. HTML code is not allowed.

buy print