中心静脉与混合静脉血氧饱和度监测术后血容量变化的比较

目的比较中心静脉血氧饱和度（ｃｅｎｔｒａｌｖｅｎｏｕｓｏｘｙｇｅｎｓａｔｕｒａｔｉｏｎ，ＳｃｖＯ２，经右心房）与混合静脉血氧饱和度（ｍｉｘｅｄｖｅｎｏｕｓｏｘｙｇｅｎｓａｔｕｒａｔｉｏｎ，ＳｖＯ２，经肺动脉）在监测心脏术后血容量（ＢＶ）变化时的意义。方法２４例心脏手术后患者，分别于术后进入ＩＣＵ处于机械通气及睡眠状态（Ⅰ组）；术后６小时处于机械通气及清醒状态（Ⅱ组）；术后２０小时处于自主呼吸及清醒状态（Ⅲ组）；同时测定ＳｃｖＯ２，ＳｖＯ２，ＢＶ和其他血流动力学指标并进行相关分析。结果ＳｃｖＯ２与ＢＶ相关系数（ｒ）分别为Ⅰ组０．５８９１（Ｐ＜０．０１），Ⅱ组０．５５９０（Ｐ＜０．０１），Ⅲ组０．６９６２（Ｐ＜０．０１）；ＳｖＯ２与ＢＶｒ分别为Ⅰ组０．７８５６，Ⅱ组０．７７８１（Ｐ＜０．０１），Ⅲ组０．７２４３（Ｐ＜０．０１）；ＳｃｖＯ２与ＳｖＯ２ｒ分别为Ⅰ组０．８６８９，Ⅱ组０．８９７１，Ⅲ组０．９５１３（Ｐ＜０．０１）。表明ＳｃｖＯ２与ＢＶ，ＳｖＯ２在心脏术后不同状态下具有相关性。结论ＳｃｖＯ２能代替ＳｖＯ２作为反映心脏术后ＢＶ变化的一种监测指标     

重症瓣膜置换术患者围术期氧供,氧耗,氧摄取率和氧合状态的变化

目的：观察重症瓣膜置换术患者围术期氧供需平衡和氧合状态的变化。方法：监测２６例重症瓣膜置换术患者围术期氧供（ＤＯ２）、氧耗（ＶＯ２、氧摄取率（ＥＲＯ２）、混合静脉血氧饱和度（ＳｖＯ２）和动脉血乳酸含量（ＡＢＬ）的动态变化。结果：麻醉诱导后至ＣＰＢ前（ＤＯ２）、ＶＯ２、ＥＲＯ２均下降，ＳｖＯ２升高，与麻醉前比较差异显著或非常显著（Ｐ＜０．０５，Ｐ＜０．０１）。停ＣＰＢ后２０小时内ＤＯ２、ＶＯ２、ＥＲＯ２持续升高，停ＣＰＢ８小时内ＳｖＯ２持续下降，ＡＢＬ持续升高，与ＣＰＢ前时值差异显著或非常显著（Ｐ＜０．０５，Ｐ＜０．０１）。结论：停ＣＰＢ后氧供需平衡障碍、组织缺氧明显存在，且有在一定时间内加重的趋势。     

门脉高压大鼠胃粘膜屏障功能的实验研究

为探讨门脉高压性胃病的发病机理，将Ｗｉｓｔａｒ大鼠４２只随机分为肝硬变组（ＬＣ组，ｎ＝１５）、门静脉狭窄组（ＰＶＳ组，ｎ＝１５）和假手术组（ＳＯ组，ｎ＝１２），以观察其血流动力学指标、胃壁结合粘液（ＧＰ）、胃粘膜内源性前列腺素Ｅ２（ＰＧＥ２）水平、胃基础泌酸量（ＢＡＳ）以及Ｈ＋返渗量（Ｈ＋ＢＤ）。结果：ＬＣ组及ＰＶＳ组大鼠内脏血流量较ＳＯ组明显增加（Ｐ＜０．００１），但胃粘膜却处于缺血状态；其ＧＰ和ＰＧＥ２含量也较ＳＯ组显著下降（Ｐ＜０．０１），其中ＬＣ组又较ＰＶＳ组更低（Ｐ＜０．０５）；ＢＡＳ３组间无差异，但ＬＣ组及ＰＶＳ组大鼠之Ｈ＋ＢＤ明显高于ＳＯ组（Ｐ＜０．００１），且以ＬＣ组最为显著。本实验结果提示：门静脉高压大鼠胃粘膜屏障功能遭到严重破坏，尤以肝硬变大鼠为甚；门脉高压性胃病的发生与胃粘膜屏障功能削弱有关；肝功能受损参与胃粘膜病变的发生。     

FDP对体外循环病人红细胞免疫功能影响的临床研究临床研究

目的　研究１,６二磷酸果糖（ＦＤＰ）对体外循环（ＣＰＢ）手术病人围术期红细胞免疫粘附功能（ＲＣＩＡ）的影响。方法　２４ 例心内直视手术患者随机分为２ 组,生理盐水（ＮＳ）组和ＦＤＰ组各１２例,两组分别于麻醉前、ＣＰＢ前、停机后５ 分钟、术后２４ 小时、术后７２ 小时抽取静脉血检测红细胞Ｃ３ ｂ 受体花环形成率（ＲＢＣ·Ｃ３ｂＲ）及红细胞免疫复合物花环形成率（ＲＢＣ·ＩＣＲ）。结果　停机后及术后２４ 小时,ＮＳ组患者ＲＢＣ·Ｃ３ｂＲ 及ＲＢＣ·ＩＣＲ 均显著下降,ＲＢＣ·Ｃ３ｂＲ 下降率分别为２７６６％ ,３２１０％ （Ｐ＜ ００１）;ＲＢＣ·ＩＣＲ下降率分别为２３２８％ ,３２１６％ （Ｐ＜ ００１）;而ＦＤＰ组停机后及术后２４ 小时,ＲＢＣ·Ｃ３ｂＲ分别降低１６１５％ ,２０３９％ ,与术前相比降低明显（Ｐ＜ ００１）;但与ＮＳ组相比,其降低程度则有所减少（Ｐ＜ ００５）;ＲＢＣ·ＩＣＲ降低分别为１８２８％ ,２２８１％ ,与ＮＳ组相比无统计学差异;术后ＲＣＩＡ 功能恢复ＦＤＰ组较ＮＳ组亦有所提高。结论　ＦＤＰ（２００ｍ ｇ／ｋｇ）于ＣＰＢ术前应用对ＲＣＩＡ有显著性保护作用     

活性同种带瓣主动脉补片重建法乐四联症右室流出道

为评价活性同种主动脉（ＣＶＡＨ）补片重建法乐四联症（ＴＯＦ）右室流出道（ＲＶＯＴ）的临床效果。以保留无冠瓣及二尖瓣大瓣的ＣＶＡＨ重建ＲＶＯＴ４０例。关胸前测定各心腔压力并行彩色多普勒超声随访。结论：关胸前测压，ＣＶＡＨ组与对照组右室收缩压／左室收缩压（ＲＶＳＰ／ＬＶＳＰ）分别为０．４９±０．０９和０．６２±０．１３（ｔ＝４．８０，Ｐ＜０．００１）；ＲＶＳＰ分别为６．３０±１．３６ｋＰａ和７．８８±２．３４ｋＰａ（ｔ＝３０．７７，Ｐ＜０．００１）；右室—肺动脉压力阶差（ＲＶ—ＰＡＰＧ）分别为０．９７±０．７９ｋＰａ和３．２９±１．９７ｋＰａ（ｔ＝６．６９，Ｐ＜０．００１）；中心静脉压（ＣＶＰ）分别为１．３２±０．２４ｋＰａ和２．０６±０．５１ｋＰａ（ｔ＝８．２１，Ｐ＜０．００１）。ＣＶＡＨ组血流动学力效果明显优于对照组。ＣＶＡＨ组手术死亡１例（２．５％），余３９例全部随访２８．３±１８．１（６～６６）个月，无远期死亡，心功能恢复优良。多普勒超声显示术后肺动脉反流轻微，ＣＶＡＨ无失功及钙化。结论：带瓣ＣＶＡＨ是理想的ＲＶＯＴ重建材料，血流动力学效果优良，可以最大限度加宽ＲＶＯＴ和减轻肺动脉反流。     

心脏手术后中心静脉压测定的临床意义

目的 探讨中心静脉压（ＣＶＰ）在心脏术后的临床意义。方法 随机选择心脏术后患者２４例,均在三种状态下进行对比研究：（１）患者术毕进入ＩＣＵ处于机械通气状态;（２）术后８小时处于机械通气及清醒状态;（３）术后２４小时处于自主呼吸和清醒状态。分别测定ＣＶＰ、血容量（ＢＶ）、心脏指数（ＣＩ）和其它血流动力学指标,对ＣＶＰ与血流动力学指标之间进行相关分析。结果 ＣＶＰ与ＢＶ在术后不同状态下均无相关性,而与     

中心静脉与混合静脉血氧饱和度监测术后血容量变？…

目的 比较中心静脉血氧饱和度（ｃｅｎｔｒａｌ ｖｅｎｏｕｓ ｏｘｙｇｅｎ ｓａｔｕｒａｔｉｏｎ，ＳｃｖＯ２，经右心房）与混合静脉血氧饱和度（ｍｉｘｅｄ ｖｅｎｏｕｓ ｓａｔｕｒａｔｉｏｎ，ＳｖＯ２，经肺动脉）在监测心脏术后血容量（ＢＶ）变化时的意义。方法 ２４例心脏手术后患者，分别于术后进入ＩＣＵ处于机械通气及睡眠状态（Ⅰ组）；术后６小时处于机械通气及清醒状态（Ⅱ组）；术后２０小时处于自主呼吸及清     

氨基酸对未成熟心肌保护作用的实验研究

研究天门冬氨酸或（和）谷氨酸强化血停搏液对未成熟心肌的保护效果。将２４只出生３～４周新西兰幼兔随机均分成４组：Ｉ组为冷血停搏液组，Ｉ组天门冬氨酸（２０ｍｍｏｌ／Ｌ）强化组，ＩＩ组谷氨酸（２０ｍｍｏｌ／Ｌ）强化组，ＩＶ组谷氨酸加天门冬氨酸（各２０ｍｍｏｌ／Ｌ）强化组。结果表明，心功能指标心输出量（ＣＯ）恢复百分率ＩＶ组、Ｉ组明显少于Ｉ组（Ｐ＜０．０１）；左室收缩压（ＬＶＳＰ）恢复百分率Ｉ、ＩＩ、ＩＶ组明显少于Ｉ组（Ｐ＜０．０１）；左室舒张压（ＬＶＤＰ）及左室压力微分（ｄｐ／ｄｔ）恢复百分率Ｉ、ＩＩ、ＩＶ组优于Ｉ组（Ｐ＜０．０５）。乳酸脱氢酶（ＬＤＨ）和磷酸肌酶（ＣＫ）漏出量（Ｕ／Ｌ）中，ＬＤＨ漏出量Ｉ组优于Ｉ组（Ｐ＜０．０５），ＩＩ、ＩＶ组明显优于Ｉ组（Ｐ＜０．０１）；ＣＫ漏出量ＩＩ、ＩＶ组明显优于Ｉ组（Ｐ＜０．０１）。Ｉ、ＩＩ、ＩＶ组心肌含水量（％）明显优于Ｉ组（Ｐ＜０．０１）。Ｉ、ＩＩ、ＩＶ组心肌结构保护明显优于Ｉ组。结论：谷氨酸或（和）天门冬氨酸强化血停搏液能明显增强对未成熟心肌的保护作用。氨基酸强化组间之所以差别不显著可能与模型有关     

卡托普利心脏停搏液对缺血再灌注心肌NOS活性和NO产生的影响

目的：探讨卡托普利心脏停搏液对缺血再灌注心肌保护作用的机制。方法：１２只绵羊,随机均分为对照组（Ｉ组）和卡托普利组（Ｉ组）。常规建立体外循环,心脏停搏６０分钟,再灌注３０分钟。Ｉ组采用仁济医院冷晶体停搏液,ＩＩ组在停搏液中加入卡托普利２３μｍｏｌ／Ｌ。观察冠状窦血中一氧化氮（ＮＯ）、肌酸磷酸激酶（ＣＰＫ）、环磷酸鸟苷（ｃＧＭＰ）、心肌丙二醛（ＭＤＡ）含量及心肌ＮＯ合酶（ＮＯＳ）同功酶活性的变化,监测心肌功能。结果：再灌注后Ｉ组心肌血ＮＯ、ＣＰＫ、ｃＧＭＰ、心肌ＭＤＡ均明显升高,Ｉ组低于Ｉ组（Ｐ＜０．０５或０．０１）。ＩＩ组再灌注后心肌原生型ＮＯ合酶（ｃＮＯＳ）活性明显高于Ｉ组,而诱导型ＮＯ合酶（ｉＮＯＳ）及总ＮＯＳ活性显著低于Ｉ组（Ｐ＜０．０１或０．００１）。两组再灌注后心肌功能均降低,Ｉ组较Ｉ组更为显著。再灌注后ＮＯ的变化与心肌ＭＤＡ和ＣＰＫ之间呈正相关（Ｐ＜０．００１和０．０１）。结论：缺血再灌注心肌损伤与过量ＮＯ产生有关,卡托普利通过调节ＮＯＳ同功酶活性,维持正常ＮＯ水平起到保护作用。     

连续温度稀释法测定心排血量的临床应用及评价

目的与方法：２０例心脏手术病人采用连续温度稀释法进行转术期ＣＯ和Ｓ＾－ｖＯ２测定。结果：（１）ＣＣＯ从诱导后至ＣＰＢ启动明显降低,ＣＰＢ后升高,关胸后下降,术后２ｈ降至最低,随后缓慢升高,４８ｈ后显著升高;（２）ＣＣＯ和ＩＣＯ高度相关,ｒ＝０．９３２（ｎ＝４０）;（３）机器Ｓ＾－ｖＯ２和血气Ｓ＾－ｖＯ２高度相关,ｒ＝０．９５４（ｎ＝３１）。结论：（１）本法测定ＣＯ和Ｓ＾－ｖＯ２标准可靠;（２）动态     

冠脉搭桥手术病人的心脏指数和混合静脉血氧饱和度的相关性研究

目的：对８５例接受３￣５根冠脉搭桥手术病人测得的围术期混合静脉血氧饱和度和心脏指数（ＣＩ）等血流动力学指标进行统计学分析，探索其相关性。方法：采用有光纤的５腔肺动脉漂浮导管，分别在六个时相采取血流动力学参数；麻醉前基础值，气管插管后５分钟，锯开胸骨后，体外循环停机后，术后６和２４小时。结果：ＳｖＯ２与ＣＩ在各时相无显著改变或高于术前水平。各时相ＳｖＯ２和ＣＩ与对照值之差间显示较好的相关性。结论：     

Perioperative circulating blood volume analysis in management of a 13-year-old female patient with an extraadrenal pheochromocytoma and refractory ventricular tachycardia: a case report

This report describes the use of discrete real-time monitoring of blood volume (BV) and cardiac index (CI) by a dye densitography analyzer before, during, and after removal of a pheochromocytoma. The BV expanded by about 1.1 L and CI increased by about 2.2-fold after the tumor was removed. In lieu of a rapid catecholamine determination, the hemodynamic data were used to choose a supplemental catecholamine to stabilize the patient during and after the protracted surgery. This case demonstrates the importance of hemodynamic monitoring (BV and CI) to predict or detect cardiac and other complications, particularly in young patients with catecholamine-secreting tumors.     

Cardiac events after combined surgery for coronary and carotid artery disease

Objective: To evaluate serious cardiac events after combined (either single or two stage) coronary artery surgery (CAS) and carotid endarterectomy (CEA) for concomitant coronary and carotid artery disease. Methods: We have analyzed our 15 year experience (January 1981–September 1996) with 201 consecutive patients operated on using both approaches. Group A consisted of 48 patients with the single-stage procedure, while in group B (153 patients), two stage procedure was carried out, either as carotid endarterectomy (CEA), followed by coronary artery bypass surgery (CAS) (group B₁⁻ 103 patients), or as CAS followed by CEA (group B₂⁻ 50 patients). Five patients from B₁ group died after the CEA procedure, but were included, despite the fact they never reached the second stage. Left main coronary artery disease was found in 41 patients (20.4%), poor left ventricular function in 49 (24.4%) previous MI in 133 (66.2%), while 136 (67.7%) were in NYHA functional class III or IV. Bilateral carotid involvement was present in 61 patients (30.3%). Unstable angina was more prevalent in groups A and B₂ (P<0.0001), NYHA class III/IV in group A (versus B₁, P=0.001 and versus B₂, P=0.02), low ejection fraction in groups A and B₂ (P<0.0001), bilateral carotid stenosis in group B₁ (versus A, P=0.003 and versus B₂, P<0.0001), and ulcerated plaque in group B₁ (P<0.0001). These differences dictated the surgical strategy, which resulted in different protocols for clinical and operative management. Results: Early mortality for the entire group was 5.5% (11/201) 6.2% in group A, 7.8% in group B₁ and 0% in group B₂, respectively; (P>0.05). Serious morbidity occurred in 7.5% of patients (8.3% in group A, 7.8% in group B₁ and 6% in group B₂, respectively; P>0.05). Univariate analysis revealed only bilateral carotid stenosis to influence early outcome (P=0.04). Conclusion: Patients with concomitant coronary and carotid artery disease have relatively good immediate operative results, providing all existing lesions are corrected. Despite it did not reach the statistical significance, cardiac events were less frequent in groups A and B₂ indicating possible protective effect of prior CAS in patients with concomitant disease.     

Strain-Encoded Cardiac Magnetic Resonance for the Evaluation of Chronic Allograft Vasculopathy in Transplant Recipients

The aim of our study was to investigate the ability of Strain-Encoded magnetic resonance imaging (MRI) to detect cardiac allograft vasculopathy (CAV) in heart transplantation (HTx)-recipients. In consecutive subjects (n = 69), who underwent cardiac catheterization, MRI was performed for quantification of myocardial strain and perfusion reserve. Based on angiographic findings subjects were classified: group A including patients with normal vessels; group B, patients with stenosis <50%; and group C, patients with severe CAV (stenosis ≥ 50%). Significant correlations were observed between myocardial perfusion reserve with peak systolic strain (r =−0.53, p < 0.001) and with mean diastolic strain rate (r = 0.82, p < 0.001). Peak systolic strain and strain rate were significantly reduced only in group C, while mean diastolic strain rate and myocardial perfusion reserve were already reduced in group B and A. Myocardial perfusion reserve and mean diastolic strain rate had higher accuracy for the detection of CAV (AUC = 0.95, 95% CI = 0.87–0.99 and AUC = 0.93, 95% CI = 0.84–0.98, respectively) and followed peak systolic strain and strain rate (AUC = 0.80, 95% CI = 0.69–0.89 and AUC = 0.78, 95% CI = 0.67–0.87, respectively). Besides the quantification of myocardial perfusion, the estimation of the diastolic strain rate is a useful parameter for CAV assessment. In combination with the clinical evaluation, these parameters may be effective tools for the routine surveillance of HTx-recipients.     

压力与容积指标在感染性休克合并心功能抑制时的临床意义

目的 对感染性休克患者进行临床研究,分析心功能抑制在感染性休克中的作用及表现.方法 回顾性分析2005年1月至2009年6月收治的77例感染性休克患者的临床资料,根据早期复苏后心排血指数(CI)分组,高CI组患者39例,低CI组患者38例,比较两组治疗达标率、诊断后28 d病死率以及全心舒张末容积指数(GEDI)随中心静脉压(CVP)变化情况.结果 (1)高CI组患者与低CI组患者年龄、急性生理及慢性健康评分(APACHEⅡ)、治疗达标率及诊断后28 d病死率差异有统计学意义(P<0.05).(2)低CI组中,有16例患者的GEDI不随CVP上升而增加,而在高CI组只有6例,差异有统计学意义(P<0.05).(3)低CI组中,GEDI不随CVP上升而增加的患者中心静脉血氧饱和度(ScvO_2)和治疗达标率较低,动脉血乳酸和病死率较高,与GEDI随CVP上升而增加的患者比较,差异有统计学意义(P<0.05).结论 GEDI与CVP的相关性可以作为反映感染性休克患者心功能变化的指标,尤其对于CI降低的患者,GEDI不随CVP上升而增加提示心功能抑制,且是预后不良的早期指标;高龄、APACHEⅡ评分高的感染性休克患者更易合并心功能抑制.     

Small dose of prostaglandin E(1) increases cardiac output without altering blood volume

STUDY OBJECTIVE: To investigate the effect of small dose of intravenous (IV) prostaglandin E(1) (PGE(1)) on blood volume (BV) and cardiac output (CO) by pulse dye-densitometry (PDD) in patients administered isoflurane anesthesia. DESIGN: Prospective, randomized study. SETTING: University hospital. PATIENTS: 14 ASA physical status I and II adult patients undergoing elective neurosurgery. INTERVENTIONS: Patients were randomly assigned to either the PGE(1) group (n = 7) or the control group (n = 7). Anesthesia was induced with thiamylal, fentanyl, and vecuronium, and maintained with isoflurane and nitrous oxide. When the cardiovascular system stabilized after craniotomy and incision of the dura mater, we administered a small dose of PGE(1) at a rate of 0.02 microg/kg/min (PGE(1) group) or saline at a rate of 2 mL/min (control group). MEASUREMENTS AND MAIN RESULTS: Blood volume, CO, and mean transit time (MTT) were measured by PDD before and 60 minutes after the start of administration. At the same timing, mean arterial pressure (MAP), heart rate (HR), and central venous pressure (CVP) were measured, and systemic vascular resistance (SVR), cardiac index (CI), and CO/BV were computed. As for MAP, there was no significant difference within a group and between groups. In the PGE(1) group, significant increases were noted in CI from 2.54 +/- 0.46 to 3.24 +/- 0.83 (mean +/- SD) L/min/m(2) (p < 0.05), in CO/BV from 0.90 +/- 0.24 to 1.19 +/- 0.33 (p < 0.05), and in HR from 65.7 +/- 10.1 to 74.9 +/- 12.1 bpm (p < 0.05), and a significant decrease was observed in MTT from 22.3 +/- 6.5 to 18.2 +/- 5.1 seconds (p < 0.05 ). Cardiac index and CO/BV in the PGE(1) group increased higher than in the control group, while BV, CVP and SVR remained consistent in both groups. CONCLUSIONS: A small dose of PGE(1), low enough not to provoke hypotension, increased CO without alterations in BV. The increase in CO seemed to be mainly due to an increase in HR.     

Predictors of prolonged mechanical ventilation in a cohort of 3,269 CABG patients

BACKGROUND: Prolonged mechanical ventilation after heart surgery is associated with increased patient morbidity and mortality (4.9% vs 22-38%). A prospective observational cohort study was carried out to assess the predictors of prolonged mechanical ventilation and its impact on hospital survival in a cardiac surgical patient cohort admitted to our 8 bed postoperative ICU from January 1997 through June 2004. METHODS: All of the patient perioperative and ICU variables were input into an electronic database. Patients were divided into: 1) an Early Extubation group, undergoing a successful extubation within 12 h and 2) a Delayed Extubation group, needing mechanical ventilation longer than 12 h. RESULTS: A total of 3,269 patients undergoing a coronary artery bypass graft operation were admitted. A multivariate Logistic Regression model allowed us to identify: 1) redo surgery (OR = 3.090, 95% CI = 1.655-5.780); 2) cardiopulmonary bypass time longer than 91' (OR = 1.390, 95% CI = 1.013-1.908); 3) intraoperative transfusions of more than 4 units of red blood cells (OR = 3.144, 95% CI = 2.331-4.255) or fresh frozen plasma (OR = 2.976, 95% CI = 1.984-4.830); and 4) left ventricular ejection fraction = or < 30% (OR = 2.444, 95% CI 1.291-3.205) as independent predictors of prolonged mechanical ventilation. The Early Extubation group showed a significantly higher cumulative survival 180 days after the ICU admission (Log-Rank = 16.617, p=0.000). CONCLUSION: This audit allowed us to assess a predictive model identifying a priori coronary artery bypass graft patients that are more likely to undergo prolonged mechanical ventilation.     

Cardiac troponin I is reliable with immediate but not medium-term cardiac complications after abdominal aortic repair

BACKGROUND: The diagnosis of cardiac complications is particularly challenging in the postoperative course of non-cardiac surgery. Follow-up of patients suggests that silent or symptomatic postoperative myocardial infarction have similar short-term outcomes. Cardiac troponin I (cTnI) has been reported as being a sensitive and specific marker of these complications. METHODS: We conducted a prospective study to determine the cut-off values of cTnI which may predict cardiac complications, i: in the postoperative period until discharge, and ii: during a 1-year period after aortic surgery. Three hundred and twenty-nine consecutive patients undergoing infrarenal aortic surgery were included over a 2-year period in a single center. cTnI was measured at recovery and on the 1st, 2nd and 3rd postoperative days. The presence or absence of cardiac complications was classified by reviewers who had no knowledge of cTnI. For evaluation of the ideal discrimination value of cTnI between the complicated and uncomplicated patient groups, we calculated receiver-operator characteristics for the mean values of the peak of cTnI. RESULTS: Thirteen patients (4%) developed 19 postoperative cardiac complications. Thirteen patients (4%) died in the postoperative period. Nine patients (3%) developed 10 cardiac complications during the 1-year follow-up in 316 patients. In 280 patients, cTnI was below 0.5 ng/ml, in 22 patients between 0.5 and 1.5 ng/ml and the 27 remaining patients had a cTnI higher than 1.5 ng/ml. The area under the curve for postoperative cardiac complications was 0.84 (SD=0.21). A limit value of 0.54 ng/ml yielded a sensitivity of 75% and a specificity of 89%. The area under the curve for late cardiac complications was 0.45 (SD= 0.13). CONCLUSION: A cTnI level greater than 0.54 ng/ml appears to be correlated with the occurrence of cardiac complications in the period until discharge, but no value of cTnI is predictive of late cardiac complications occurring in the 1st year after aortic surgery.