Effect of Desflurane on Cardiac Function During Cardiac Surgery: Tissue Doppler Imaging of Mitral Valve Annular Velocity

Konkuk University Medical Center

Status: Unknown

Conditions: Valvular Heart Disease

Treatments: Drug: increment of desflurane

Study type: Interventional

Funder types: Other

Identifiers

NCT02003885

KUH1160063

Details and patient eligibility

About

The purpose of this study is to determine desflurane's dose-dependent effect on left ventricular (LV) function in cardiac surgery. The change of tissue Doppler imaging (TDI) of lateral mitral valve annular velocity at three different desflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (TEE) in cardiac surgery patients

Full description

Tissue Doppler imaging (TDI ) of mitral annular velocity during the cardiac cycle has been introduced as a reliable method for analysis of systolic and diastolic LV ling-axix function , efficacy of diastolic TDI profile, including early early relaxation (E') and atrial contraction (A') and has been suggested to be useful in predicting the postoperative clinical outcomes and the impact of isoflurane on LV diastolic function.

Desflurane is widely used in cardiac surgery patients due to its beneficial effects , but many studies have shown that desflurane reduces myocardial contractility in a dose-dependent manner, and compromises left ventricular( LV) function We hypothesized that desflurane , even at a clinical dosage, would affects intraoperative LV systolic function in a dose-dependent manner and thus produce significant changes int the TDI profiles of mitral annular velocity.

So we planned to study the changes in TDI profiles of lateral mitral annular velocity at the clinical desflurane dosage during remifentanil based anesthesia for cardiac surgery

Enrollment: 14 estimated patients

Sex: All

Ages: 20 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Ages eligible for study : 20 years to 65 years Genders eligible for study : Both

Inclusion Criteria:

• Patients undergoing cardiac surgery

Exclusion Criteria:

• Low ejection fraction <50% in preoperative transthoracic echocardiography
• Atrial fibrillation
• Pacemaker
• Pericardial and infiltrative myocardial disease
• Mitral annular calcification, surgical rings, prosthetic mitral valves
• Lateral left ventricular regional wall motion abnormality
• Esophageal spasm, stricture, laceration, perforation, and diverticulum
• Diaphragmatic hernia
• History of extensive radiation to mediastinum
• Upper gastrointestinal bleeding

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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14 participants in 1 patient group

Desflurane increment

Experimental group

Description:

increment of desflurane 0.5-1.5 MAC in remifentanil anesthesia for cardiac surgery

Treatment:

Drug: increment of desflurane