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Chest, Vol 93, 1144-1147, Copyright © 1988 by American College of Chest Physicians

ARTICLES

The effects of rapid volume expansion on the right and left cardiac filling pressures after coronary artery bypass surgery

I Pacold, MH Hwang, RT Palac, PJ Scanlon and HS Loeb
Section of Cardiology, Hines Veterans Administration Hospital, IL 60141.

Rapid volume expansion is a diagnostic procedure which can reveal typical hemodynamics of pericardial constriction in patients with pericardial disease who have normal hemodynamics in their baseline state. We studied 20 patients with previous coronary artery bypass surgery in order to determine whether this operation results in some degree of pericardial constriction which could be demonstrated by rapid volume expansion. After infusing 1 L of physiologic saline solution over six minutes, the right atrial pressure increased by 5 +/- 2 mm Hg, the right ventricular diastolic pressure by 4 +/- 3 mm Hg, the pulmonary capillary wedge pressure by 7 +/- 3 mm Hg, and the left ventricular diastolic pressure by 7 +/- 4 mm Hg (mean +/- SD). Equalization of the left and right cardiac pressures was not observed, and the normal respiratory variation of the pressures was not altered by rapid volume expansion. Thus, the pericardial manipulation associated with the performance of coronary artery bypass surgery does not commonly result in the development of subclinical pericardial constriction.




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Copyright © 1988 by the American College of Chest Physicians.