Konishi Y, Matsumoto M, Yuasa S, Miwa T, Nishizawa J
Department of Cardiovascular Surgery, Wakayama Red Cross Hospital, Japan.
Kyobu Geka. 1994 Aug;47(9):705-8.
Postoperative right ventricular function was evaluated serially by thermodilution techniques (REF-1, Edwards Laboratories) in patients who underwent aorto-coronary bypass surgery with uneventful postoperative recovery. The patients were divided into three groups depending on the location of critical stenosis of the right coronary artery. The stenosis was proximal to the right ventricular branch in group I (n = 13), distal to the right ventricular branch but proximal to the acute marginal branch in group II (n = 13) and distal to the acute marginal branch in group III (n = 11). Control (n = 20) consisted of the patients with no significant stenosis of the right coronary artery. Cardiac index, intracardiac pressures and amount of cathecolamin used during postoperative course showed no significant differences among the groups including control. With the use of cathecolamine after surgery, right ventricular ejection fraction (RVEF) rose and right ventricular volumes (RVEDV and RVESV) decreased in all the groups except for group I. These values in group I were unchanged. Thus, there were significant differences in RVEF, RVEDV and RVESV between group I and control. These results mean that right ventricular dysfunction may remain even long after occlusion of the proximal right coronary artery.
对术后恢复顺利的接受主动脉冠状动脉搭桥手术的患者，采用热稀释技术（REF-1，爱德华兹实验室）连续评估术后右心室功能。根据右冠状动脉严重狭窄的位置，将患者分为三组。I组（n = 13）狭窄位于右心室分支近端，II组（n = 13）狭窄位于右心室分支远端但在锐缘支近端，III组（n = 11）狭窄位于锐缘支远端。对照组（n = 20）为右冠状动脉无明显狭窄的患者。术后过程中的心脏指数、心腔内压力及儿茶酚胺使用量在包括对照组在内的各组间无显著差异。术后使用儿茶酚胺后，除I组外所有组的右心室射血分数（RVEF）升高，右心室容积（RVEDV和RVESV）降低。I组的这些值未改变。因此，I组与对照组在RVEF、RVEDV和RVESV方面存在显著差异。这些结果意味着即使在右冠状动脉近端闭塞很长时间后，右心室功能障碍仍可能存在。
