Differential Effect of Prostaglandin E₁ and Nitroglycerin on Right Ventricular Performance During Infrarenal Aortic Cross-clamping

Abstract

Hemodynamic responses to infrarenal aortic cross-clamping during abdominal aortic aneurysm surgery have been reported. However, no studies have reported on right ventricular performance during aortic cross-clamping. In this report, the effect of infrarenal aortic cross-clamping on right and left ventricular performance with prosta-glandin E₁ (PGE₁) or nitroglycerin (TNG) was examined with the right ventricular ejection fraction/volumetric catheter (Baxter). PGE₁ attenuated increase of systemic vascular resistance and decrease of cardiac output due to increase of afterload during aortic cross-clamping. PGE₁ also maintained right ventricular end systolic and end diastolic volume. TNG decreased right ventricular end diastolic volume by decreasing venous return and did not attenuate increase of systemic vascular resistance during aortic cross-clamping. Our findings suggest that PGE₁ be commonly recommended during infrarenal aortic cross-clamping, and TNG is useful for patients with augmented right ventricular volume.