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Ann Thorac Surg 1996;62:231-232
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 225.

DR JOSEPH I. MILLER, JR (Atlanta, GA): First I would like to thank Dr Reed for the excellent presentation and the opportunity of reviewing the manuscript.

Doctor Reed has postulated that right ventricular pump dysfunction defined by a decreased right ventricular ejection fraction occurs after pulmonary resection. I would raise three issues. Clinically what are the implications of the study? I think they can be looked at threefold. In lobectomy, with appropriate physiologic criteria, the effect on right ventricular function of resection probably has little value; I realize that in your manuscript you said that there were only a few of the patients who had undergone pneumonectomy, and I think that is where the real clinical importance of your study probably is. The publication of Kirklin's classic paper on the effect of preload on postpneumonectomy pulmonary edema in 1981 essentially eliminated postpneumonectomy pulmonary edema by fluid restriction in the majority of pneumonectomy patients.

I would like to ask you, what do you think the value of measurement of right ventricular ejection fraction may play in evaluation of the pneumonectomy patient? Also equally . . . [Full Text of this Article]


Related Article

Mechanisms of Right Ventricular Dysfunction After Pulmonary Resection
Carolyn E. Reed, B. Hugh Dorman, and Francis G. Spinale
Ann. Thorac. Surg. 1996 62: 225-231. [Abstract] [Full Text]





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