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严重血流动力学状况是由右心室切开术和游离壁梗死引起的,还是由功能失调的右心室后负荷的微小变化引起的?

Does a critical hemodynamic situation develop from right ventriculotomy and free wall infarct or from small changes in dysfunctional right ventricle afterload?

作者信息

Fantidis P, Castejon R, Fernández Ruiz A, Madero-Jarabo R, Cordovilla G, Sanz Galeote E

机构信息

Experimental Surgery Department, Hospital La Paz, Facultad de Medicina, Universidad Autonoma, Madrid, Spain.

出版信息

J Cardiovasc Surg (Torino). 1992 Mar-Apr;33(2):229-34.

PMID:1572883
Abstract

An experimental model for right ventricle free wall infarct associated with double ventriculotomy and tricuspid insufficiency was created to evaluate whether right ventricle failure can cause profound refractory heart failure or whether modifications in right ventricular afterload are more influential in this regard. In our model, the left ventricle, interventricular septum and right atrial wall were maintained intact and pulmonary banding made it possible to modify right ventricular afterload during the experiment. The results of our study showed that pure right ventricular failure does affect the hemodynamic state negatively, but it is not itself, a cause of death in dogs. A slight increase in the dysfunctional right ventricular afterload produced a profound deterioration in the hemodynamic state that required pulmonary artery debanding within no more than 10 minutes.

摘要

建立了一种与双心室切开术和三尖瓣关闭不全相关的右心室游离壁梗死实验模型,以评估右心室衰竭是否会导致严重的难治性心力衰竭,或者右心室后负荷的改变在这方面是否更具影响力。在我们的模型中,左心室、室间隔和右心房壁保持完整,肺动脉环扎术使在实验过程中改变右心室后负荷成为可能。我们的研究结果表明,单纯的右心室衰竭确实会对血流动力学状态产生负面影响,但它本身并不是导致犬死亡的原因。功能失调的右心室后负荷略有增加会导致血流动力学状态严重恶化,需要在不超过10分钟内解除肺动脉环扎。

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