Effects of rapid volume expansion on the right filling pressures after prosthetic valve surgery

Authors

  • Reuben Ilia MD,

    1. Division of Cardiology and the Department of Epidemiology, Soroka Medical Center, Ben-Gurion University School of Health Sciences, Beer-Sheva, Israel
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  • Shimon Weizman MD,

    1. Division of Cardiology and the Department of Epidemiology, Soroka Medical Center, Ben-Gurion University School of Health Sciences, Beer-Sheva, Israel
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  • Prof. Moshe Gueron MD

    Corresponding author
    1. Division of Cardiology and the Department of Epidemiology, Soroka Medical Center, Ben-Gurion University School of Health Sciences, Beer-Sheva, Israel
    • Division of Cardiology, Soroka Medical Center, P.O. Box 151, Beer-Sheva 84101, Israel
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Abstract

The effects of rapid intravascular volume expansion were studied in 12 patients, 4 to 14 years after single prosthetic heart valve replacement. The data observed showed a statistically significant mean difference before and after volume expansion of right atrial mean pressure and right ventricular end diastolic and pulmonary capillary pressures. However, right atrial and pulmonary capillary pressures equilibration was not detected. The right atrial pressure form showed abnormal variations during inspiration. Dip and plateau right ventricular diastolic pressure configuration was recorded in 6 patients after expansion, was absent in 2 and questionable in 4. A deep Y descent with an M-shaped right atrial pressure form was recorded in all 12 patients. The explanation for these phenomena is unclear.

Thus, in the absence of pressure equilibration and clinical evidence of constriction, the abnormalities recorded during rapid volume expansion should be cautiously interpreted.

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