Is left ventricular venting necessary in open heart surgery

: In this study we intended to clarify the benefits of left ventricular venting by comparing the surgical results and clinical courses of 19 adult patients who underwent open heart procedures with venting and those of 44 adult patients who had open heart procedures without venting. All of the patients of both groups underwent operations for acquired heart diseases. The hospital mortality was 10.5% in the vent group and 2.3% in the no-vent group (NS). None of the deaths occurred due to the postoperative low output syndrome in either group. The incidence of spontaneous defibrillation was not different in the two groups, and no patients required postoperative IABP support in either group. The number of patients who needed catecholamine infusion for longer than 24 hours postoperatively were not statistically different in the two groups, and incidence of ventricular arrhythmias was not different in the two groups. The cardiac index determined 6 hours postoperatively was significantly higher in the no-vent group. The left atrial pressure in the no-vent group did not exceed 10 mmHg during cardiopulmonary bypass, if the central venous pressure was maintained below 7 mmHg. It was suggested that distension of the left ventricle and myocardial injuries do not occur during cardiopulmonary bypass without left ventricular venting, provided the central venous pressure is maintained below 6 or 7 mmHg.