Dilated aortic root influences pulmonary artery catheter placement in anesthetized patients
نویسندگان
چکیده
Purpose The placement of a pulmonary artery catheter sometimes needs long time by observing the pressure wave, and several factors have been reported to hinder the placement. In the present study, we examined whether enlargement of the aortic root is associated with longer time for the placement. Method We examined the time required for the catheter placement. The catheter placement time was defined as the duration of time required for the catheter to float from the CVP position to the pulmonary artery. The catheter placement was performed by one experienced physician. We examined the following factors on the catheter placement time: the patient's age, height, weight, cardiothoracic ratio, tricuspid regurgitation, ejection fraction and the diameter of aortic annulus, sinus of Valsalva, sinotubular junction, and proximal ascending aorta. These diameter values were divided by body surface area (BSA) to equalize among different physical sizes. The data were analyzed by multiple linear regression analysis after univariate analysis. Results The univariate analysis showed that ejection fraction and aortic annulus/BSA, sinus of Valsalva/BSA, and sinotubular junction/BSA correlated with the catheter placement time (P = 0.079, 0.030, 0.029, and 0.025, respectively). Since the three aortic root values correlated with each other, we chose the sinotubular junction/BSA for the following multivariate analysis, because of the highest P value. The multivariate analysis showed that sinotubular junction/BSA had a significant positive association with the placement time (P = 0.048). Conclusion The present study showed that enlargement of the aortic root is associated with long placement time of the catheter.
منابع مشابه
An analysis of the factors influencing pulmonary artery catheter placement in anesthetized patients
BACKGROUND Pulmonary artery catheters are usually placed by resident anesthesiologists with pressure wave monitoring from educational point of view. In some cases, the placement needs longer time or is difficult only by observing the pressure waves. AIMS We sought to examine the time required for the catheter placement in adult patients and determine factors influencing the placement. SETTI...
متن کاملInvasive arterial BP monitoring in trauma and critical care: effect of variable transducer level, catheter access, and patient position.
OBJECTIVES (1) To determine the validity of current recommendations for direct arterial BP measurement that suggest that the transducer (zeroed to atmosphere) be placed level with the catheter access regardless of subject positioning: and (2) to investigate the effect of transducer level, catheter access site, and subject positioning on direct arterial BP measurement. DESIGN Prospective, cont...
متن کاملDetection of patent ductus arteriosus with intraoperative transesophageal echocardiography in a patient undergoing closure of coronary artery to pulmonary artery fistula
Background Coronary artery to pulmonary artery fistula is an unusual vascular anomaly, and the shunt ratio of this fistula is usually small. Case presentation We report anesthetic management of a 55-year-old female with annuloaortic ectasia, aortic valve regurgitation, and coronary artery to pulmonary artery fistula undergoing radical repair. We calculated the left-to-right shunt ratio after ...
متن کاملValve-sparing neoaortic root replacement late after the Norwood and Fontan procedures.
Neoaortic root dilatation is a significant and inevitable late complication in patients after the Norwood operation. In this report, we describe a patient who had left pulmonary artery compression and severe neoaortic regurgitation from a severely dilated neoaortic root 11 years after the Norwood operation and subsequent Fontan procedure. We performed successful valve-sparing neoaortic root rep...
متن کاملRoss procedure at the crossroads.
The quest for a perfect heart valve substitute has been going on for half a century. In 1960, Lower et al1 described the feasibility of replacing the aortic valve of dogs with the native pulmonary valve. In 1967, Ross performed this procedure in humans.2 Ross transferred the pulmonary valve into the aortic root with the same technique used to implant aortic valve homograft3 (ie, the pulmonary s...
متن کامل