CORONARY VASCULAR TONE AFTER CORONARY BYPASS OPERATIONS

这项临床研究验证了冠状动脉血流动力学 的患者可能在冠状动脉造影后即刻发生改变， 可能对患者未来病程有害的旁路手术， 不被承认。 将热稀释导管置入冠状动脉 静脉窦穿孔并连接到心大静脉 港口分布 允许对前心肌进行采样， 近端取样整个左心室 血液样本用于 测定局部耗氧量、酸碱平衡、乳酸、 丙酮酸、肌酸激酶和乳酸脱氢酶同工酶 浓度的 进行完整的血流动力学评价 术前及术后6- 8h连续观察。 六 患者进行了全面的研究。 在某些情况下， 冠状血管阻力、心输出量或任何生化指标， 变量发生。 其他患者表现出的变化可能与较少的 比最佳的收缩力和体循环流量更重要。 控制心率 通过心房起搏和预负荷可以消除一些这种可变性。 动物研究表明，使用光纤，热稀释， 导管将允许在线记录心肌代谢趋势。 这样的连续测量将允许更好地评估冠状动脉流量 未来患者研究的动态。

This clinical study tests the hypothesis that coronary blood flow dynamics of patients may be altered in the immediate interval after a coronary bypass procedure which may be deleterious to the patient's future course if unrecognized. A thermal dilution catheter is placed into the coronary sinus percutaneously and threaded to the great cardiac vein. Ports located at the tip allow sampling of the anterior myocardium and those more proximal sample the entire left ventricle. Blood samples are used to determine regional oxygen consumption, acid base balance, lactic acid, pyruvate, creatine kinase, and lactic dehydrogenase isoenzyme concentrations. Complete hemodynamic evaluations are performed preoperatively and in serial fashion for 6-8 hours after operation. Six patients have had complete studies. In some, no significant changes in coronary vascular resistance, cardiac output, or any of the biochemical variables occur. Other patients show changes which can be related to less than optimal contractility and systemic flow. Control of heart rate through atrial pacing and preload may eliminate some of this variability. Animal studies indicate that the use of a fiberoptic, thermodilution catheter will allow on-line documentation of myocardial metabolic trends. Such continuous measurement will allow better assessment of coronary flow dynamics in future patients studies.