Центральная гемодинамика и нарушения ритма сердца в периоперационном периоде реконструктивных операций на брахиоцефальных артериях при цереброваскулярных заболеваниях

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To optimize the perioperative treatment cardiovascular events and central hemodynamics were investigated in 39 patients with ischemic cerebrovascular diseases undergoing endovascular or open reparative operation in brachiocephalic arteries. Transthoracic echocardiography, 24-hour bifunctional ECG and blood pressure monitoring were performed before and 24-28 hours after operation. In early postoperative period arterial hypotension time index, supraventricular extrasystole, short paroxysms of supraventricular tachycardia were raised. In the same time ventricular arrhythmia activation, episodes of silent myocardial ischemia were not registered. Administration of beta-blockers prevented palpitation and increasing of cardiac output and caused noticeable lowering of systemic blood pressure as compared to baseline. Episodes of bradyarrhythmia were not registered. 11% of patients who were not treated with beta-blockers developed angina attacks after operation. Our results showed that beta-blockers are effective in perioperative period to prevent myocardial ischemia and do not cause dysfunction of sinoatrial node. Vasodepressive reaction was observed in early postoperative period irrespective of type of previous drug treatment. Beta-blockers induced greater lowering of blood pressure though was not accompanied with clinical signs of cerebral hypoperfusion.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery