J.Jpn. Surg. Soc.. 81(7): 622-631, 1980

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Original article

HEMODYNAMIC STUDY IN PATIENTS WITH AORTIC ANEURYSM BY THERMODYLUTION CATHETER

Hemodynamics of 11 patients with aortic aneurysms (4 thoracic and 7 abdominal) were studied by Swan-Ganz Catheter before, during and after operation. The values of PAP, PWP, RAP and CO were measured by Swan-Ganz Catheter and cardiac output computer and, from these data CI, TPR, PAR, LVSWI, RVSWI, LW, and RW were calculated.
The results obtaind as follows; 1) the hemodynamograms of 12 values (CI, PR, SBP, PAP, PWP, RAP, TPR, PAR, LVSWI, RVSWI, LW and RW) showed 5 different patterns: normal pattern, hypovolemic pattern, heart failure pattern, hyperdynamic pattern and overhydration pattern.
2) Preopertive hemodynamograms, which were constructed in five of the patients showed almost normal patterns, though two were mildly hyperdynamic and one was mildly hypovolemic.
3) The change in intra-operative hemodynamograms were pursued in one patient, who had his abdominal aorta replaced with a Y-shaped graft. The patient demonstrated heart failure pattern after induction of anesthesia and overhydration pattern before aortic cross-clamping. Then patient showed normol pattern at 10ｰ40min. after aortic cross-clamping, hypovolemic pattern at 60 min. and normal pattern at 90 min. After release of the aortic and common iliac cross-clampings, hemodynamogram was an overhydration pattern.
4) According to the hemodynamogram on the first postoperative day, the patients were divided into three groups (H, N and C groups). The H group consisted of three patients who had hyperdynamic patterns, and the N group of 6 patients having normal patterns. These two groups showed an uneventful course. The C group consisted of two patients with heart failure patterns, who died of heart failure on the 6th and 13th postoperative day.

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