Pulmonary-cardiac hemodynamics in patients with major surgical interventions on the lungs according to the data of doppler echocardiography

Abstract

Introduction. The choice of the optimal scope of inter- ventions for major operations on the lungs, including reconstructive plastic surgery, combined pneumonectomy, depends, among other things, on the degree of decrease in the functional reserves of the cardiovascular system.
The study aims the evaluation of the functional state of the right ventricle (RV) of the heart, the level of secondary pulmonary hypertension before and after major surgical interventions on the lungs. Materials and methods. The study included 32 patients aged 41 to 74 years (29 men and 3 women) who underwent pneumonectomy with circular resection of the tracheal bifurcation and various types of combined pneumonectomy. The control group consisted of 37 practically healthy individuals aged 23 to 59 years (17 men and 20 women). Doppler echocardiography was used to study the parameters of the pulmonary circulation (before and 3–5 days after the operation).
Results. As possible alternative indicators characterizing the state of the pumping function of theRV, it is possible to recommend the use of the systolic shortening fraction (SSF) of theRV, the amplitude of movement of the tricuspid valve ring and the end-diastolic size of theRV. Decreased SSF of the RV below 0,2, amplitude of movement of the tricuspid valve ring less than 1,6 cm, and dilatation of the RV over 3.5 cm in diastole may indicate a pronounced decrease in the contractile function of the RV. Conclusion.
In patients with initially impaired hemodynamics, functional changes after surgical interventions were more pronounced. The boundaries of the shift of the main ultrasound parameters of the right ventricular function were determined to form a group of increased prognostic risk.