Lung resections and heart-lung haemodynamics

Abstract

Aim. The aim was to identify the effects of pulmonary resection on right ventricular performance and the possible contribution to mortality and morbidity. Material and Methods. We examined the patients with Doppler Echocardiography before the operation and 1 week and 4 months after the pulmonary resection. Systolic, diastolic and stroke volumes as well as right ventricular ejection fraction were estimated. Pulmonary arterial pressure was calculated using the level of tricuspid regurgitation and subtracting method. Right ventricular end diastolic volume (RVEDV) and volume index increased, the heart rate (HR) also increased and the ejection fraction (EF) decreased in patients after lung resections. We evaluated 80 patients with major pulmonary resections due to carcinoma of the lung. We divided the patients in 2 groups: the first contained 40 patients with previous complications such as myocardial infarct, arrhythmias, pulmonary hypertension or COPD and the second also contained 40 patients but without previous complications. Results. The main parameters to predict the postoperative hemodynamic status and cardiac complications after the resection were: TPVRI (total pulmonary vascular resistance index), m PAP (mean pulmonary arterial pressure), CI (cardiac index) and RVD right ventricular dimension. Pulmonary resection causes dilatation and dysfunction on right ventricle in the early postoperative period. Early detection can provide the chance for interventional therapy. Conclusion. We concluded that there were changes in the parameters (s PAP, RVEDV, RVEDD, HR, EF) in both groups. We also concluded that the main parameters we have to use in order to predict the appiriance of postoperative complications are TPVRI, PAP, CI and RVD.