Why the study?
Does thoracotomy increase pulmonary vascular resistance in the early postoperative period?
Does thoracotomy increase pulmonary vascular resistance in the early postoperative period?
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Thoracotomy is associated with a marked early postoperative increase in pulmonary vascular resistance, which can be fatal in patients with pre-existing pulmonary hypertension.
Introduction STUDY of pulmonary vascular resistance following thoracotomy in the human has largely been confined to the late postoperative period.1We have measured pulmonary vascular resistance (PVR) preoperatively and in the early postoperative period. A marked elevation at this time is the reason for this presentation. Our interest in the changes in PVR immediately following thoracotomy was stimulated in the early days of open-heart surgery at our institution, when, in error, we operated on a patient with primary pulmonary hypertension. The death of this patient 48 hours later from unrelenting pulmonary hypertension (as gathered by indirect means) in a clinical state of low cardiac output implied an elevation of the PVR. A similar mode of death in the first few postoperative days was experienced in certain patients with high resistance type of ventricular septal defect. Could this be due to an increase in PVR following thoracotomy? If this same
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John C. Coles (1965) studied this question.
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