| The Relationship Between Central Venous Pressure and Pulmonary Capillary Wedge Pressure in Patients with Aortic Stenosis. |
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Eun Sook Yoo, Young Lan Kwak, Yong Woo Hong, Sou Ouk Bang, Choon Soo Lee, Gee Moon Lee, Hyun Kyo Lim |
1Department of Anesthesiology, Yonsei Cardiovascular Center and research institute, Yonsei University College of Medicine, Seoul, Korea.
2Department of Anesthesiology, Yonsei University Wonju College of Medicine, Wonju, Korea. |
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| Abstract |
BACKGROUND
Hemodynamic monitoring during aortic valve replacement in patients with aortic stenosis is controversial and there are little prospective data on which to base an enlightened clinical decision. The relationship between central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) was examined in patients with aortic stenosis.
METHODS
30 patients with aortic stenosis who underwent aortic valve replacement were examined. For each patient, simultaneous measurements of CVP, pulmonary artery diastolic pressure (PADP) and PCWP were made at pre-and post-cardiopulmonary bypass. After cardiopulmonary bypass, measurement of left atrial pressure(LAP) was made.
RESULTS
The PCWP correlated well with PADP(r=0.86 p<0.01, r=0.79 p<0.01) and LAP (r=0.89 p<0.01) at pre- and post-bypass. The CVP did not correlate with PADP(r=0.22 p>0.05, r=0.45 p>0.05), PCWP(r=0.39 p<0.01, r=0.53 p<0.01) and LAP(r=0.53 p<0.05) at pre- and post-bypass. The changes in CVP and PCWP also correlated poorly at pre- and post-bypass (r=0.16 p>0.05, r=0.51 p<0.05).
CONCLUSIONS
This study confirmed the disparities between CVP and PCWP which were anticipated in aortic stenosis. This disparity seems due to marked differences between either compliance or function of the two ventricles. Therefore, CVP monitoring in aortic stenosis is limited value and may mislead in management. |
| Key Words:
Monitoring; central venous pressure; pulmonary capillary wedge pressure; Heart; aortic stenosis |
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