Diagnosis and therapy of intracardiac shunt caused by ventricular septal defect after cardiac surgery: the roleof a complex approach to hemodynamic monitoring

Paromov K.V.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

ORCID: 0000-0002-5138-3617

Lenkin P.I.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

Nizovtsev N.V.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Putanov M.A.

Clinical City Hospital №1 n.a. E.E. Volosevich, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

Panov O.S.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Bystrov D.O.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Shonbin A.N.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

ORCID: 0000-0002-1361-7945

Kirov M.Yu.

FSBEI HE NSMU MOH Russia

SPIN RSCI: 2025-8162
Scopus AuthorID: 7004841942
ORCID: 0000-0002-4375-3374

Diagnosis and therapy of intracardiac shunt caused by ventricular septal defect after cardiac surgery: the roleof a complex approach to hemodynamic monitoring

Authors:

Paromov K.V., Lenkin P.I., Nizovtsev N.V., Putanov M.A., Panov O.S., Bystrov D.O., Shonbin A.N., Kirov M.Yu.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2018;(6): 104‑108

DOI: 10.17116/anaesthesiology2018061104

Downloaded: 34

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Paromov KV, Lenkin PI, Nizovtsev NV, et al. . Diagnosis and therapy of intracardiac shunt caused by ventricular septal defect after cardiac surgery: the roleof a complex approach to hemodynamic monitoring. Russian Journal of Anesthesiology and Reanimatology. 2018;(6):104‑108. (In Russ.)
https://doi.org/10.17116/anaesthesiology2018061104

Close metadata

We present a clinical case of diagnosis of an incisional ventricular septal defect after myoseptectomy due to hypertrophic cardiomyopathy using complex hemodynamic monitoring, which included echocardiography, transpulmonary thermodilution and pulmonary artery catheterization. Concurrent use of these techniques has allowed to diagnose and interpret the source of acute heart failure and cardiogenic shock after cardiac surgery, and to confirm indications for surgical correction, as well as to close the intracardiac shunt. The closure led to regress of hemodynamic and metabolic disorders and to complete recovery of the patient.

Keywords:

hemodynamic monitoring

intracardiac shunt

cardiac surgery

Authors:

Paromov K.V.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

ORCID: 0000-0002-5138-3617

Lenkin P.I.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

Nizovtsev N.V.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Putanov M.A.

Clinical City Hospital №1 n.a. E.E. Volosevich, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

Panov O.S.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Bystrov D.O.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia

Shonbin A.N.

E.E.Volosevich First Arkhangelsk Municipal Hospital, 163001, Arkhangelsk, Russia;
Northern State Medical University, 163000, Arkhangelsk, Russia

ORCID: 0000-0002-1361-7945

Kirov M.Yu.

FSBEI HE NSMU MOH Russia

SPIN RSCI: 2025-8162
Scopus AuthorID: 7004841942
ORCID: 0000-0002-4375-3374

List of references:

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. Heart disease and stroke statistics — 2016 update; a report from Fvtrican Heart Association. Circulation. 2016;133(4): e38-e360. https://doi.org/10.1161/CIR.0000000000000350
Ross J, Braunwald E. Aortic stenosis. Circulation. 1968;38(1 suppl.):61-67.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3^rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;63(22):e57-e185. https://doi.org/10/1161/CIR.0000000000000029
Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecci F, Charron P, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy. 2014. Russ J Cardiol. 2015;5(121):7-57. (In Russ.) https://doi.org/10/16829/1560-4071-2015-05-7-57
Varma PK, Raman SP, Neema PK. Hypertrophic cardiomyopathy part II — Anesthetic and surgical considerations. Ann Card Anaesth. 2014;17:211-221.
Manecke GR, Asemota A, Michard F. Tackling the economic burden of postsurgical complications: would perioperative goal-directed fluid therapy help? Crit Care. 2014;18(5):566. https://doi.org/10.1186/s13054-014-0566-1
Cannesson M, Pestel G, Ricks C, Hoeft A, Perel A. Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists. Crit Care. 2011; 15(4):R197. https://doi.org/10.1186/cc10364
Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40(12):1795-1815. https://doi.org/10.1007/s00134-014-3525-z
Doherty JU, Kort S, Mehran R, Schoenhagen P, Soman P. ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate use of criteria for multimodality imaging in valvular heart disease. J Am Coll Cardiol. 2017;70(13):1647-1672. https://doi.org/10.1016/j.jacc.2017.07.732
Krichevsky LA, Rybakov VYu, Guseva OG, Kharlamova IE, Makovetskaya EA, Urbanov AV, et al. Obstruction of the outflow tract of the left ventricleduring cardiac surgery. Anesthesiology and reanimatology [Anestheziologiya i reanimatologiya]. 2015;(5):31-34. (In Russ.)
Khomenko EA. Apparent and potential role of transesophageal echocardiography in open heart surgery: clinical and educational aspects. Messenger of intensive care. Vestnik intensivnoy terapii. 2015;5(suppl.):64. (In Russ.)
Kaneko T, Kawamura Y, Maekawa T, Tagami T, Nakamura T, Saito N, et al. Global end-diastolic volume is animportant contributor to increased extravascular lung water in patients with acute lung injury and acute respiratory distress syndrome: a multicenter observational study. J Intensive Care. 2014; 2(1):25. https://doi.org/10.1186/2052-0492-2-25
Kuzkov VV, Kirov MYu. Invasive monitoring of hemodynamics: Monograph. 2nd ed. Arkhangelsk: Northern state medical university; 2015;392. (In Russ.)
Jacquet L, Hanique G, Glorieux D, Matte P, Goenen M. Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med. 1996;22(10):1125-1129.
Pérez AC, Eulmesekian PG, Minces PG, Schnitzler EJ. Adequate agreement between venous oxygen saturation in right atrium and pulmonary artery in critically ill children. Pediatr Crit Care Med. 2009;10(1):76-79. https://doi.org/10.1097/PCC.0b013e318193699d
Feltracco P, Biancofiore G, Ori C, Saner FH, Della Rocca G. Limits and pitfalls of haemodynamic monitoring systems in liver transplantation surgery. Minerva Anestesiol. 2012;78(12):1372-1384.

Close metadata