Evaluation of left ventricular function in coronary bypass surgery

Objectives-To evaluate non-invasive indexes measuring systolic and diastoli c ventricular function. Eleven coronary artery bypass grafting (CABG) patie nts were investigated in order to assess the ability of preoperative ejecti on fraction (EF) and end diastolic pressure (EDP) to predict left ventricul ar function determined non-invasively at surgery. Design-End-systolic elastance (Ees) was assessed perioperatively using tran soesophageal echocardiographic area estimation and arterial pressure monito ring during preload variations (caval balloon). Diastolic function was eval uated using three different echo/Doppler indexes. Results-EF correlated positively to Ees (r=0.69, p=0.03). No correlations w ere found between EDP and the perioperative diastolic indexes. Ees fell fro m pre-bypass to post-bypass (from 9.0 +/- 2.7 to 4.7 +/- 1.7 mmHg/cm(2), me an +/- SD, p < 0.001), but no alterations in diastolic parameters occurred. Conclusions-A positive correlation was found between preoperative EF and Ee s at surgery. The semi-invasive Ees detected a systolic "stunning" after ca rdiopulmonary bypass and is promising as a surveillance tool for left ventr icular perioperative function and treatment. No correlations between preope rative EDP and non-invasive diastolic indexes were found, and assessment of perioperative diastolic function needs further refinement.