Published in:
01-08-2007 | ORIGINAL ARTICLE
The Dicrotic Pulse: A Common, Non-Ominous Finding After the Ross Operation
Authors:
B. J. Barber, R. L. Donnerstein, T. W. Secomb, K. Pogreba-Brown, R. Steelman, M. S. Ellenby, I. Shen, R. M. Ungerleider
Published in:
Pediatric Cardiology
|
Issue 4/2007
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Abstract
We noted a dicrotic pulse in several patients following a Ross operation. Although the etiology of this unique arterial waveform is not completely understood, it has been reported as a sign of low cardiac output and a poor prognosis. We reviewed preoperative echocardiograms and postoperative radial arterial pressure tracings in 33 patients who underwent a Ross procedure between 2000 and 2004. We found a dicrotic pulse to occur commonly (20/33; 61%) following a Ross operation. Moderate to severe preoperative aortic insufficiency was present in 19/20 patients (95%) in whom a dicrotic pulse was noted and in only 3/13 (23%) who did not exhibit a postoperative dicrotic pulse (p < 0.001). A dicrotic pulse was not associated with an increased use of vasoactive infusions or longer hospitalization following the Ross operation. The dicrotic pulse should be recognized as a common postoperative finding in Ross patients that does not herald a delayed postoperative convalescence. The mechanism for a dicrotic pulse in these patients is speculative but may result from changes in vascular compliance secondary to chronic aortic insufficiency.