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Swan-Ganz Catheter (swan-ganz + catheter)
Selected AbstractsCardiac function during mild hypothermia in pigs: increased inotropy at the expense of diastolic dysfunctionACTA PHYSIOLOGICA, Issue 1 2010H. Post Abstract Aim:, The induction of mild hypothermia (MH; 33 °C) has become the guideline therapy to attenuate hypoxic brain injury after out-of-hospital cardiopulmonary resuscitation. While MH exerts a positive inotropic effect in vitro, MH reduces cardiac output in vivo and is thus discussed critically when severe cardiac dysfunction is present in patients. We thus assessed the effect of MH on the function of the normal heart in an in vivo model closely mimicking the clinical setting. Methods:, Ten anaesthetized, female human-sized pigs were acutely catheterized for measurement of pressure,volume loops (conductance catheter), cardiac output (Swan-Ganz catheter) and for vena cava inferior occlusion. Controlled MH (from 37 to 33 °C) was induced by a vena cava inferior cooling catheter. Results:, With MH, heart rate (HR) and whole body oxygen consumption decreased, while lactate levels remained normal. Cardiac output, left ventricular (LV) volumes, peak systolic and end-diastolic pressure and dP/dtmax did not change significantly. Changes in dP/dtmin and the time constant of isovolumetric relaxation demonstrated impaired active relaxation. In addition, MH prolonged the systolic and shortened the diastolic time interval. Pressure,volume analysis revealed increased end-systolic and end-diastolic stiffness, indicating positive inotropy and reduced end-diastolic distensibility. Positive inotropy was preserved during pacing, while LV end-diastolic pressure increased and diastolic filling was substantially impaired due to delayed LV relaxation. Conclusion:, MH negatively affects diastolic function, which, however, is compensated for by decreased spontaneous HR. Positive inotropy and a decrease in whole body oxygen consumption warrant further studies addressing the potential benefit of MH on the acutely failing heart. [source] Evaluation of Left Ventricular Diastolic Function after Edge-to-Edge Mitral Valve PlastyJOURNAL OF CARDIAC SURGERY, Issue 1 2010Yong-Qiang Lai M.D. This procedure anchors the correspondence leaflets to create a double-orifice mitral valve. The original mitral valve anatomy is changed, and the opening of mitral valve is restricted. Little is known whether this procedure affects the left ventricular diastolic function. Methods: Thirty patients with mitral regurgitation were included in this study. Fifteen with posterior leaflet prolapse received quadrangular resection (group 1), 15 with anterior or bileaflet prolapse underwent edge-to-edge procedure (group 2). Acute hemodynamics was monitored with a Swan-Ganz catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Left ventricular diastolic function was also evaluated with echocardiography in 28 patients with sinus rhythm. The ratio of peak E velocity and A velocity (E/A), the ratio of early diastolic peak flow velocity to early diastolic mitral annular movement velocity (E/Em), and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity (Em/Am) were measured before operation and one week after operation. Results: Mitral valve area and mitral regurgitate grade decreased significantly after operation. There was no significant change in pulmonary artery wedge pressure between two groups and in each group before and after operation. Echocardiography evaluation showed there was no significant difference in E/A, E/Em, and Em/Am before and after operation between two groups and in each group. Conclusion: Edge-to-edge mitral valve plasty procedure has no significant impairment on left ventricular diastolic function. A double-orifice mitral valve has similar hemodynamic behavior with a physiological valve.(J Card Surg 2010;25:5-8) [source] Hemodynamic Changes in a Model of Chronic Heart Failure Induced by Multiple Sequential Coronary Microembolization in SheepARTIFICIAL ORGANS, Issue 11 2009Jan Dieter Schmitto Abstract Although a large variety of animal models for acute ischemia and acute heart failure exist, valuable models for studies on the effect of ventricular assist devices in chronic heart failure are scarce. We established a stable and reproducible animal model of chronic heart failure in sheep and aimed to investigate the hemodynamic changes of this animal model of chronic heart failure in sheep. In five sheep (n = 5, 77 ± 2 kg), chronic heart failure was induced under flouroscopic guidance by multiple sequential microembolization through bolus injection of polysterol microspheres (90 µm, n = 25.000) into the left main coronary artery. Coronary microembolization (CME) was repeated up to three times in 2 to 3-week intervals until animals started to develop stable signs of heart failure. During each operation, hemodynamic monitoring was performed through implantation of central venous catheter (central venous pressure [CVP]), arterial pressure line (mean arterial pressure [MAP]), implantation of a right heart catheter {Swan-Ganz catheter (mean pulmonary arterial pressure [PAPmean])}, pulmonary capillary wedge pressure (PCWP), and cardiac output [CO]) as well as pre- and postoperative clinical investigations. All animals were followed for 3 months after first microembolization and then sacrificed for histological examination. All animals developed clinical signs of heart failure as indicated by increased heart rate (HR) at rest (68 ± 4 bpm [base] to 93 ± 5 bpm [3 mo][P < 0.05]), increased respiratory rate (RR) at rest (28 ± 5 [base] to 38 ± 7 [3 mo][P < 0.05]), and increased body weight 77 ± 2 kg to 81 ± 2 kg (P < 0.05) due to pleural effusion, peripheral edema, and ascites. Hemodynamic signs of heart failure were revealed as indicated by increase of HR, RR, CVP, PAP, and PCWP as well as a decrease of CO, stroke volume, and MAP 3 months after the first CME. Multiple sequential intracoronary microembolization can effectively induce myocardial dysfunction with clinical and hemodynamic signs of chronic ischemic cardiomyopathy. The present model may be suitable in experimental work on heart failure and left ventricular assist devices, for example, for studying the impact of mechanical unloading, mechanisms of recovery, and reverse remodeling. [source] Transfemoral percutaneous removal of a knotted Swan-Ganz catheter,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 5 2009Athanasios Katsikis MD Abstract Intracardiac knotting of balloon-tipped flow-directed catheters during a heart catheterization procedure represents a rare but serious complication. In case that such an event occurs, leading to inability to remove the catheter, various different methods have been described to solve the problem, varying from the least invasive to open heart surgery. The formation of large knots requires surgical removal in the vast majority of cases. We describe the successful nonsurgical removal of a Swan-Ganz catheter, after the formation of a large double knot, during a right heart catheterization performed without fluoroscopic guidance in the intensive care unit. This technique could serve as a last resort in cases that surgical removal seems inevitable due to size-related inapplicability of other nonsurgical methods. © 2009 Wiley-Liss, Inc. [source] | ||||||||||