Effects of biatrial infusion on intraoperative hemodynamics after cardiopulmonary bypass in patients undergoing correction of complex congenital heart disease

AIM:To investigate the effects of biatrial infusion on the intraoperative hemodynamics after cardiopulmonary bypass (CPB) in patients undergoing correction of complex congenital heart disease complicated by pulmonary hypertension (PH). METHODS: Fortysix NYHA class II or III patients (aged 6 months to 5 years and weighing 5-19 kg) undergoing corrective surgery for complex congenital heart disease complicated by PH were randomly divided into two groups (n=23 each). Group I was the double atrial infusion group in which drugs with vasoconstrictive and positive inotropic effect were pumped via the left atrium and drugs with vasodilative effect were pumped via the right atrium or pulmonary artery. Group II was the right atrial infusion group in which vasoconstrictive and positive inotropic drugs and vasodilative drugs were pumped directly via the right atrium. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before drug administration (T0) as well as 5, 10, 30 and 60 min after drug administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. RESULTS: Compared with those at T0, MAP, MPAP, PCWP and PVRI significantly decreased, whereas CI increased at T1-4 in group II and MAP, CI and SVRI significantly increased. HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group II (P<005). Compared with those in group II, MAP, CI and SVRI were significantly higher and HR, MPAP, PCWP, PVRI and CVP were lower (P<005). CONCLUSION: Biatrial infusion can effectively reduce PAP and PVRI and increase CI after CPB during correction of complex congenital heart disease complicated by PH.