Trastornos hemodinamicos

ORIGINAL ARTICLE

Rev Bras Cir Cardiovasc 2007; 22(4): 407-415

Hemodynamic disorders related to beating heart surgery using cardiac stabilizers: experimental study
Alterações hemodinâmicas devido ao uso de estabilizadores em revascularização do miocárdio: estudo experimental
Pedro Paulo Martins de OLIVEIRA1, Domingo Marcolino BRAILE2, Reinaldo Wilson VIEIRA3, Orlando PETRUCCI JUNIOR4,Lindemberg Mota SILVEIRA FILHO5, Karlos Alexandre de Sousa VILARINHO6, Elaine Soraia de Oliveira BARBOSA7, Nilson ANTUNES8
RBCCV 44205-922
Abstract Objective: To study in swine the hemodynamic changes secondary to the use of stabilizers for off-pump coronary artery bypass graft surgeries by means of both a suction device “Octopus” and a compression device (Speroni). Methods: Ten swine underwentmedian sternotomy. Monitoring of ECG, continuous cardiac output, mean arterial pressure, mean pulmonary artery pressure, mean right and left atrial pressures, and right and left ventricular diastolic pressure were performed. Stroke volume and systemic vascular resistance were calculated. Both stabilizers were studied placed on three vessels: anterior interventricular branch, posterior interventricularbranch, and the left marginal artery of the circumflex branch. Each animal was randomly designed to application regarding the type of stabilizer and the target artery. The measurements were carried out 5 minutes before and after the stabilizer application. Results: In the anterior interventricular branch changes have occurred only with the compression device, thus reducing cardiac output, strokevolume, and mean arterial pressure, but increasing the systemic vascular resistance. In the posterior interventricular branch changes have occurred with the compression device (Speroni), reducing cardiac output and stroke volume, but increasing the heart rate. With the suction device (octopus) there was an increase of both heart rate and systemic vascular resistance, but a decrease in strokevolume. In the left marginal artery of the circumflex branch there was a decrease of cardiac output, stroke volume, and mean arterial pressure with both stabilizers. Also, there was a decrease in the mean pulmonary artery pressure and an increase in the mean right atrial pressure with the compression device (Speroni). Conclusion: Both stabilizers have caused hemodynamic changes. The compression device(Speroni) is more associated with changes than the suction device (Octous).

Descriptors: Myocardial revascularization, methods. Heart, physiopathology. Hemodynamics. Intraoperative period. Animal models.

1. Master Degree in Surgery - Faculdade de Ciências Médicas* – UNICAMP**; Cirurgião Cardiovascular do Hospital das Clínicas*** da UNICAMP**. 2. Ph.D. Professor - Universidade Gama Filho;Ph.D. Professor of Cardiovascular Surgery - Faculdade de Ciências Médicas* da UNICAMP** e FAMERP****. Director of Post Graduation – São José do Rio Preto Medical School. Editor of the Brazilian Journal of Cardiovascular Surgery. 3. Surgery Ph.D. Professor - Faculdade de Ciências médicas* da UNICAMP**; Associate Professor – Departament of Surgery Faculdade de Ciências Médicas* da UNICAMP**. 4.Doctorate Degree in Surgery - Faculdade de Ciências Médicas* da UNICAMP**; Ph.D. Professor Cardiovascular Surgery - Faculdade de Ciências Médicas* da UNICAMP**. 5. Master Degree in Surgery - Faculdade de Ciências Médicas* da UNICAMP**; Cardiovascular Surgeon at Hospital das Clínicas*** da UNICAMP**. 6. Surgery post-graduate student - Faculdade de Ciências Médicas* – UNICAMP**; Cardiovascular Surgeon atHospital de Clínicas*** da UNICAMP**. 7. Postgraduate Specializing; Cardiovascular Surgery Resident Physician - Faculdade de Ciências Médicas* da UNICAMP**.

8. Master Degree in Surgery - Faculdade de Ciências Médicas* da UNICAMP**; Perfusionist at Hospital de Clínicas*** da UNICAMP**. * Faculty of Medical Sciences ** State University of Campinas *** Clinics Hospital of the State University of...