J.Jpn. Surg. Soc.. 81(3): 203-213, 1980

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Original article

PRE-AND POSTOPERATIVE HEMODYNAMICS IN ACQUIRED HEART DISEASES

Hemodynamics in acquired heart diseases were studied in 45 patients before and after operation using hemodynamograms with 12 parameters (CI, PR, mAP, PAP, PwP, RAP, TPR, PAR, LVSWI,RVSWI, LW and RW). These parameters were measured and calculated by the Swan-Ganz flow directed catheter and the thermodilution cardiac output computer.
The results obtained from the hemodynamograms are as follows:
1) The patterns of hemodynamograms were classified into four patterns一(1)Normal pattern,(2) Star pattern, (3) Right dominant pattern (4), Left dominant pattern.
2) The majority of hemodynamograms in acquired heart diseases showed Right dominant pattern and no one showed Left dominant pattern.
3) There were no relationship between the age and the patterns of the hemodynamograms.
4) The history of the disease in the cases with Normal pattern, Star pattern was relatively short,however those in the cases with Right dominant pattern was comparatively long.
5) Cardio-thoracic ratio in the cases with Star pattern and Right dominant pattern showed higher values compared with those with the Normal pattern.
6) CIs of the cases with Normal pattern and Star pattern were over 2.5 l/min/m², while those of all cases with Right dominant pattern were below 2.5 l/min/m².
7) PwP values of the cases with Star pattern and Right dominant pattern showed higher values compared with those with the Normal pattern.
8) Postoperative changes of hemodynamograms were classified into five types. These types were further divided into Improved group and Non-improved group. The postoperative recovery on Improved group was uneventful and that of Non-improved group was not so well.
9) Preoperative findings of Improved group showed NYHA III, CI over 2.0 l/min/m², mPwP within 25 mmHg, and these of Non-improved group showed NYHA IV, CI below 2.0 l/min/m², mPwP over 25 mmHg.
10) CTR on Improved group and the majority of Non-improved group decreases a year after operation. CTR increased in three out of nine cases in Non-improved group.

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