VENTRICULAR FUNCTION DURING CARDIAC SURGERY

这些研究将检验后天性的手术矫正的效果。 和先天性心脏病对心脏收缩和舒张期功能的影响 成人、儿童和婴儿的左、右脑室。 将使用最先进的测量设备和算法来 术中测量和长期随访。改进型水泵 矫正手术中的功能将与 心肌特性，因为收缩和顺应性受损可以 被改善的血流动力学所掩盖。用于特定的操作，其中 手术矫正的病理生理学还不是很清楚，具体的 将确定促进长期成果取得成功的机制。 门诊研究将检查脑室大小的慢性变化和 功能，这将与术中事件有关。实验室 研究将开发术中研究的先进方法，并减少 这类研究的成本，使这项技术得到广泛应用。 术中测量包括微量压力计测量压力、流量 由电磁或超声波流量计测量，尺寸由 声学显微测量、二维超声心动图和心脏 阻抗。舒张末容量将与舒张末相关 压力测量顺应性，并与压力-体积冲程功 测量收缩功能(预负荷可恢复的每搏功)。 收缩能力也将通过压力-体积环来测量(完 收缩压-体积关系)。舒张末压力--心脏 绩效关系也将被衡量，因为这些直接 会影响患者的症状。这些目标将通过一个 敬业的教职员工将临床经验和 有效和安全地进行这些研究的实验室背景。 结果将改善心脏手术患者的护理 澄清当前管理的不足，将扩大对 心脏手术的病理生理学，并将使低成本的方法 对收缩和舒张期特性的研究通常可用于 心脏外科医生和实验室科学家。

These studies will examine the effect of surgical correction of acquired and congenital heart disease on the systolic and diastolic properties of the left and right ventricles in human adults, children, and infants. State of the art measuring devices and algorithms will be employed for intraoperative measurements and long-term follow-up. Improved pump function during corrective surgery will be correlated with changes in myocardial properties, since impaired contractility and compliance can be hidden by improved hemodynamics. For specific operations in which the pathophysiology of surgical correction is not well understood, specific mechanisms that promote a successful long term result will be defined. Outpatient studies will examine chronic changes in ventricular size and function, which will be related to intraoperative events. Laboratory studies will develop advanced methods for intraoperative study and reduce the cost of such studies, making the technology widely available. Intraoperative measurements will include pressure by micromanometer, flow by electromagnetic or ultrasonic flowmeter, and dimensions by sonomicrometry, two-dimensional echocardiography, and ventricular impedance. End-diastolic volume will be correlated with end-diastolic pressure to measure compliance, and with pressure-volume stroke work to measure contractile function (preload recruitable stroke work). Contractility will also be measured from pressure-volume loops (end- systolic pressure-volume relation). End-diastolic pressure-ventricular performance relations will also be measured, since these directly influences patient symptoms. These goals will be accomplished by a dedicated faculty with the right combination of clinical experience and laboratory background to conduct these studies effectively and safely. Results will improve care of patients undergoing cardiac surgery, will clarify deficiencies of current management, will expand understanding of the pathophysiology of heart surgery, and will make low cost methods for the study of systolic and diastolic properties generally available to cardiac surgeons and laboratory scientists.