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

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):

• TDI of lateral mitral annulus at systole (S'), early filling (E') and atrial contraction (A')
• transmitral flow Doppler at early filling (E), atrial contraction (A), deceleration time;
• LV-ejection fraction (EF)
• bispectral index (BIS)
• phenylephrine-infusion rate
• 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)

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