Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Johnson, P. E.
Right arrow Articles by Gordon, L. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Johnson, P. E., Jr.
Right arrow Articles by Gordon, L. S.
(Chest. 1974;66:50-56.)
© 1974 American College of Chest Physicians

Evaluation of the Immediate Effect of Aortocoronary Saphenous Vein Bypass Surgery on Myocardial Contractility

Paul E. Johnson Jr. M.D., F.C.C.P.1; Hilton Buggs M.A., M.S.; Kinji Ishikawa M.D.2; Carter A. Printup Jr. M.D.3; John R. F. Penido M.D., F.C.C.P.3; Bert H. Cotton M.D., F.C.C.P.3; and L. Stephen Gordon M.D.1

1 Division of Physiology, The Cardiovascular Diagnostic Laboratory; Department of Cardiology, The Huntington Memorial Hospital and Medical Center, Pasadena
2 Division of Physiology, The Cardiovascular Diagnostic Laboratory. Department of Cardiology, The Huntington Memorial Hospital and Medical Center, Pasadena
3 Department of Thoracic and Cardiovascular Surgery, The Huntington Memorial Hospital and Medical Center

In order to evaluate the immediate effects of aortocoronary saphenous vein bypass graft surgery on myocardial contractility, studies were carried out in 24 patients with severe occlusive disease of the right or left coronary arteries or both. Myocardial contractility was expressed by the extrapolated maximal velocity of contractile elements shortening (Vmax) and peak (dP/dt)/KP (Vpm) as calculated from the left ventricular pressure and its rate of pressure rise, dP/dt by employment of a needle connected transducer. Studies were made with the patient in sinus rhythm and a stable circulation and no cardiac action drug administration before and after saphenous vein bypass surgery. The patients were divided into two groups: group 1 (12 patients) were those without LV aneurysm and satisfactory myocardial contractility (Vmax 1.40±0.07 and Vpm 1.08±0.06 muscle lengths per second), and group 2 consisted of 12 patients with poor initial myocardial contractility (Vmax±standard error 0.94±0.05 and Vpm 0.74±0.05 muscle lengths per second) and LV aneurysm. In group 1 patients there was a significant increase in Vmax and Vpm values from preoperative results (Vmax±standard error 1.84±0.09 and Vpm 1.39±0.07 muscle lengths per second (p<0.0025 and p<0.0025, respectively)). Group 2 patients did not show any significant change in Vpm values (Vpm±standard error 0.80±0.07 muscle lengths per second, p<0.35) and only a slight change in Vmax (Vmax 1.02±0.07, p<0.0125), but five out of 12 of the changes were negative (Table 5). These preliminary data indicate that increased blood supply to the myocardium delivered by aortocoronary saphenous vein bypass graft surgery is beneficial and increase myocardial contractility in those patients with good preoperative contractility.

Submitted on July 18, 1974
Accepted on January 30, 1974






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1974 by the American College of Chest Physicians.