ABSTRACT
Objective To investigate the effects of biatrial infusion on pulmonary artery pressure (PAP)after cardiopulmonary bypass (CPB) in patients undergoing mitral valve replacement.Methods Twenty NYHA Ⅱ or Ⅲ patients aged 22-53 yr weighing 34-57 kg undergoing mitral valve replacement complicated by pulmonary hypertension (mean pulmonary artery pressure (MPAP) ＞ 50 mm Hg) were randomly divided into 2 groups ( n = 10 each): infusion via right atrium group (group R) and infusion via both atria group (group B). After induction of anesthesia, a three cavity floating Swan-Ganz catheter was placed via right internal jugular vein to monitor CVP,PAP, pulmonary capillary wedge pressure (PCWP) and CO. The patients received infusion of prostaglandin E1 30-150 ng· kg- 1 · min - 1 and phenylephrine 0.2-0.6 μg· kg- 1 · min- 1 via central veins in group R and infusion of prostaglandin E1 30-150 ng·kg-1 ·min-1 via central veins and phenylephrine 0.2-0.6 μg·kg-1 ·min-1 via left atrium in group B. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before administration (T0), and 5,10, 30 and 60 min after administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. Results D:\1111111111\MDB\zhmzxzz98201008.mdbCompared with the value at T0, MAP, MPAP, PCWP and PVRI were significantly decreased, while CI was increased at T1-4 in group R, and MAP, CI and SVRI were significantly increased, while HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group B ( P ＜ 0.05).MAP, CI and SVRI were significantly higher, while HR, MPAP, PCWP, PVRI and CVP lower in group B than in group R ( P ＜ 0.05). Conclusion Biatrial infusion can effectively reduce PAP and pulmonary vascular resistance after CPB in patients undergoing mitral valve replacement.