Sevoflurane's Effect on Mitral Valve Annular Velocity in Cardiac Surgery

Early Phase 1CompletedNCT01511991

Konkuk University Medical Center20 enrolled

Overview

The purpose of this study is to determine sevoflurane's dose-dependent effect on left ventricular (LV) function in cardiac surgery. The change of tissue Doppler imaging (TDI) of lateral mitral valve annular velocity at three different sevoflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (TEE)in cardiac surgery patients.

Following data would be determined after 10 min-exposure to each dosage of sevoflurane with 1.0, 2.0 and 3.0 inspired vol% (T1, T2 and T3, respectively) during remifentanil-based anesthesia (1.0 mcg/kg/min) for cardiac surgery (n=14): 1. TDI of lateral mitral annulus at systole (S'), early filling (E') and atrial contraction (A') 2. transmitral flow Doppler at early filling (E), atrial contraction (A), deceleration time; 3. LV-ejection fraction (EF) 4. bispectral index (BIS) 5. phenylephrine-infusion rate 6. other pressure derived hemodynamic parameters:heart rate; systolic, diastolic, and mean blood pressures; systolic, diastolic, and mean pulmonary artery pressures; central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), mixed venous O2 saturation (SvO2), cardiac index (CI) and stroke volume index (SVI)

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

SINGLE

Enrollment

Conditions

Valvular Heart Disease

Interventions

Sevoflurane dosage titrationDRUG

comparisons of the effect of the 10 min-inhalation of each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3)

Eligibility

Sex: ALLMin age: 20 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients undergoing cardiac surgery Exclusion Criteria: * low ejection fraction \< 50% in preoperative transthoracic echocardiography * atrial fibrillation * pacemaker * pericardial and infiltrative myocardial disease * mitral annular calcification, surgical rings, prosthetic mitral valves * lateral left ventricular regional wall motion abnormality * esophageal spasm,stricture, laceration, perforation, and diverticulum * diaphragmatic hernia, * history of extensive radiation to the mediastinum * upper gastrointestinal bleeding

Locations (1)

Konkuk University Medical Center

Seoul, Seoul, South Korea

Outcomes

Primary Outcomes

Peak mitral annular velocity during systole (S')

By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, S' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively)

Time frame: after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol%

Peak mitral annular velocity during early filling (E')

By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, E' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively)

Time frame: after 10 min exposure to sevoflurane of 1.0 vol%, 2.0 vol% and 3.0 vol%

peak mitral annular velocity during atrial contraction(A')

By using pulsed Doppler with the sample volume positioned at the lateral MV ring in the midesophageal 4-chamber view, A' would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively)

Time frame: after 10 min exposure to sevoflurane 1.0 vol%, 2.0 vol% and 3.0 vol%

Secondary Outcomes

ejection fraction (EF)

By using modified Simpson technique in the midesophageal 4-chamber view, EF would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively)

Time frame: after 10 min exposure to sevoflrane 1.0vol%, 2.0 vol% and 3.0 vol%

bispectral index (BIS)

BIS would be determined just after the 10 min-exposure to each concentration of sevoflurane, 1.0 inspired vol%, 2.0 inspired vol% and 3.0 inspired vol% (T1, T2 and T3, respectively)

Data from ClinicalTrials.gov

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