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Cirugía cardíaca (francés-inglés)

ADVANTAGES AND INDICATIONS OF NITRATE
VASODILATOR AGENTS IN CARDIAC SURGERY
UNDER EXTRA-CORPOREAL CIRCULATION

(A report of 47 cases)

by: J. HELMER, B. THIRION, R.KIPPER, D. AMREIN, P. MATHIEU

Summary:

Sodium nitroprusside (SNP) and trinitrin (TNT) were used in 10.7 % of cardiovascular operations for acquired cardiopathies conducted under extra-corporeal circulation (ECC) over a period of 21 months, making a total of 47 cases.

The breakdown of the conditions for which these drugs were used is as follows:

• 19 cases of SNP for peri-operative hypertensive attacks. Nineteen successes.
• 23 cases of either SNP (12 cases) or of TNT (11 cases) for the treatment of low cardiac output with high pre-load ± high after-load, in association with an inotropic drug and/or intra-aortic contra-pulsion balloon (IACPB). There were 11 successes and 12 failures (9 deaths).
• 3 cases of TNT for left ventricular failure, refractory to digitalis and diuretic therapy.
• 2 cases of SNP for left ventricular hypertrophy following increased after-load.

All the clinical and hemodynamic results were in favor of the use of nitrate vasodilator agents in the various hemodynamic situations encountered during the course of extra-corporeal circulation.

Key-words:

Cardiac surgery
Nitrated vasodilator agents