We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Assessment of Myocardial Performance and Optimal Volume Loading During Elective Abdominal Aortic Aneurysm Resection

Harry L. Bush Jr, MD; Frank W. LoGerfo, MD; Richard D. Weisel, MD; John A. Mannick, MD; Herbert B. Hechtman, MD
Arch Surg. 1977;112(11):1301-1306. doi:10.1001/archsurg.1977.01370110035003.
Text Size: A A A
Published online


• Myocardial depression has been suggested as a cause of declamping hypotension. To investigate and manage this problem, thermal dilution catheters were placed in 22 elderly, high-risk patients (mean age 71 years) who underwent elective abdominal aortic aneurysm resection. There were no deaths. Myocardial performance curves (MPC) were determined preoperatively, following induction of anesthesia, during aortic clamping, following declamping, and 12 to 48 hours postoperatively. The slope of this curve was taken as an index of myocardial performance. Preoperative cardiac index at a pulmonary artery wedge pressure of 10 mm Hg (CI10) decreased significantly following induction of anesthesia (P <.002) and persisted during aortic cross-clamping. Following declamping, CI10 rose to preoperative levels. The slope of the MPC followed this same pattern. There was no significant change in blood pressure with the aorta clamped or following declamping. Myocardial performance is depressed following induction of anesthesia but declamping hypotension can be minimized or prevented by optimum volume loading as guided by Starling's myocardial performance curves.

(Arch Surg 112:1301-1306, 1977)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.