Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Relationship of regional wall motion abnormalities detected by biplane transesophageal echocardiography and electrocardiographic changes in patients undergoing coronary artery bypass graft surgery.
It has been demonstrated that new regional wall motion abnormalities (RWMAs) are infrequently associated with electrocardiographic (ECG) ischemic changes during coronary artery bypass graft (CABG) surgery. The evaluation of apical or basal areas by biplane transesophageal echocardiography (TEE) may clarify the relationship between RWMA and ECG changes. ⋯ Biplane TEE provides additional information about spatial distribution of new RWMAs. This study was the first to demonstrate that a clear relationship between TEE and ECG ischemia exists. When these new RWMAs exhibited a large spatial distribution, the frequency of ECG ischemic changes increased.
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Early effects of coronary artery bypass surgery and cold cardioplegic ischemia on left ventricular diastolic function: evaluation by computer-assisted transesophageal echocardiography.
Although left ventricular (LV) systolic function undergoes a temporary decrease after cardiopulmonary bypass (CPB) in patients undergoing coronary artery bypass grafting (CABG), data on the effects of CABG and cardioplegic arrest on LV diastolic function are contradictory. The objective of the present study was to further evaluate the effects of CABG and CPB on LV diastolic function. ⋯ Both the active and passive components of LV diastolic function are well maintained shortly after CABG and cardioplegic arrest in patients with a good preoperative systolic LV function.
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Randomized Controlled Trial Clinical TrialEffects of dobutamine and enoximone on transmitral and pulmonary venous flow characteristics in patients with left ventricular dysfunction after coronary artery bypass grafting.
To assess the effects of dobutamine and enoximone on transmitral (TMF) and pulmonary venous flow (PVF) characteristics. ⋯ There were no major differences in parameters reflecting diastolic function between the dobutamine- and the enoximone-treated groups.
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Cocaine toxicity and isoflurane anesthesia: hemodynamic, myocardial metabolic, and regional blood flow effects in swine.
Increasing numbers of people use cocaine recreationally and may require anesthesia care, having recently abused the drug. However, no data currently exist concerning potential interactions between toxic levels of cocaine and volatile anesthetic agents. This study investigated the effects of cocaine infusion on systemic hemodynamics, myocardial metabolism, and regional organ blood flow in relation to depth of isoflurane anesthesia. ⋯ Moderately toxic cocaine levels occurring during isoflurane at 0.75 MAC and 1.5 MAC are associated with hemodynamic abnormalities, a marked increase in systemic vascular resistance, and a tendency to produce cardiac arrhythmias. A reversal of endo/epicardial myocardial perfusion ratio occurs associated with cocaine infusion during ISO anesthesia. This is probably not related to a primary redistribution of subendocardial blood flow and may be related to a combination of increased myocardial oxygen demand and epicardial coronary vasoconstriction. The reductions in cerebral and spinal cord perfusion observed may explain, in part, the neurologic sequelae of cocaine toxicity.
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Effects of nitroglycerin infusion on segmental wall motion abnormalities after anesthetic induction.
To assess the effect of intravenous nitroglycerin (NTG) on segmental wall motion abnormalities (SWMAs) and global ventricular function after anesthetic induction in patients undergoing coronary artery bypass grafting (CABG). ⋯ Intravenous NTG improved postinduction SWMAs in 75% of patients with known coronary artery disease. TEE-guided NTG infusion after induction may provide an optimal baseline echocardiogram for monitoring intraoperative myocardial ischemia by improving the reversible portion of postinduction SWMAs.