The influences of nicorandil on pulmonary hemodynamics in the cardiac valve replacement surgery for patients with rheumatic heart disease complicated with pulmonary hypertension LI Jinke, FU Jianjun, ZHANG Yongguo, LI Zhibin. Department of Surgery, Second Hospital of Laohekou, Hubei Province, Laohekou 441800, China
Abstract：Objective To observe the effect of nicorandil on pulmonary hemodynamics in rheumatic heart disease ( RHD) complicated with pulmonary arterial hypertension ( PH) patients underwent cardiac valve replacement surgery. Met-hods Sixty cases of RHD combined with PH for valve replacement were randomly divided into 2 groups, 30 cases in each group. The observation group patients received oral nicorandil before anesthesia, patients in the control group without taken any medicine. The 2 groups of patients' relevant indicators, operation body hemodynamic index and mean pulmonary artery pressure (MPAP), pulmonary vascular resistance (PVR) and the pulmonary hemodynamic parameters were observed and compared. Results Observation group's intraoperative amount of sodium nitroprusside were significantly lower than in the con-trol group ( t =3. 673, P <0. 05), and cardiopulmonary bypass time, aortic cross-clamping time, operative time, dopamine dosage,mechanical ventilation time,intraoperative amount of bleeding, intraoperative fluid volume, urine and other periopera-tive differences did not show statistically significant ( P >0. 05); using the preoperative (T0) as a reference, administered nicorandil 20 min ( T1 ) , administered 40 min ( T2 ) , before bypass ( T3 ) , the observation group's MPAP and PVR were sig-nificantly decreased ( P <0. 05), control group did not show significant decrease ( P >0. 05), 2 group's differences were statistically significant ( P <0. 05), other hemodynamic indices in the intra-group showed statistically significant differences P<0. 05), no statistically significant differences between the 2 groups were found ( P >0. 05). Conclusion Application of nicorandil in patients with RHD combined PH during aortic valve replacement can reach stable bypass blood circulation, re-duce the pressure of pulmonary artery and pulmonary circulation resistance, it is efficacy and safety for helping to guarantee the operation.
Keywords：NicorandilHeart diseaserheumaticPulmonary hypertensionHeart valve replacementHemodynamics
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 117-120 )