Valvular Heart Disease
Conditions
Keywords
cardiac surgery, sevoflurane, tissue Doppler
Brief summary
The purpose of this study is to determine sevoflurane's dose-dependent effect on left ventricular (LV) function in cardiac surgery. The change of tissue Doppler imaging (TDI) of lateral mitral valve annular velocity at three different sevoflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (TEE)in cardiac surgery patients.
Detailed description
Following data would be determined after 10 min-exposure to each dosage of sevoflurane with 1.0, 2.0 and 3.0 inspired vol% (T1, T2 and T3, respectively) during remifentanil-based anesthesia (1.0 mcg/kg/min) for cardiac surgery (n=14): 1. TDI of lateral mitral annulus at systole (S'), early filling (E') and atrial contraction (A') 2. transmitral flow Doppler at early filling (E), atrial contraction (A), deceleration time; 3. LV-ejection fraction (EF) 4. bispectral index (BIS) 5. phenylephrine-infusion rate 6. other pressure derived hemodynamic parameters:heart rate; systolic, diastolic, and mean blood pressures; systolic, diastolic, and mean pulmonary artery pressures; central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), mixed venous O2 saturation (SvO2), cardiac index (CI) and stroke volume index (SVI)
Interventions
DRUGSevoflurane dosage titration
comparisons of the effect of the 10 min-inhalation of each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3)
Sponsors
Konkuk University Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing cardiac surgery
Exclusion criteria
* low ejection fraction \< 50% in preoperative transthoracic echocardiography * atrial fibrillation * pacemaker * pericardial and infiltrative myocardial disease * mitral annular calcification, surgical rings, prosthetic mitral valves * lateral left ventricular regional wall motion abnormality * esophageal spasm,stricture, laceration, perforation, and diverticulum * diaphragmatic hernia, * history of extensive radiation to the mediastinum * upper gastrointestinal bleeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peak mitral annular velocity during systole (S') | after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol% | By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, S' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
| Peak mitral annular velocity during early filling (E') | after 10 min exposure to sevoflurane of 1.0 vol%, 2.0 vol% and 3.0 vol% | By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, E' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
| peak mitral annular velocity during atrial contraction(A') | after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol% | By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, A' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ejection fraction (EF) | after 10 min exposure to sevoflrane 1.0vol%, 2.0 vol% and 3.0 vol% | By using modified Simpson technique in the midesophageal 4-chamber view, EF would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
| peak velocity of mitral inflow during atrial contraction (A) | after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol% | By using pulsed Doppler with the sample volume positioned at the tip of MV oeneing in the midesophageal 4-chamber view, A would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
| bispectral index (BIS) | after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol% | BIS would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
| peak velocity of mitral inflow during early relaxation (E) | after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol% | By using pulsed Doppler with the sample volume positioned at the lMV opening in the midesophageal 4-chamber view, S' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively) |
Countries
South Korea
Outcome results
None listed