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.
Similar content being viewed by others
References
Barner HB, Willman VL, Kaiser GC (1970) Dicrotic pulse after open heart operation. Circulation 42:993–997
Brown DV (2002) Dicrotic pulse in pericardial tamponade. J Cardiothorac Vasc Anesth 16:742–745
Ewy GA, Rios JA, Marcus FI (1969) The dicrotic arterial pulse. Circulation 39:655–661
Flemming WJ (1881) Pulse dicrotism. J Anat Physiol 15:278–291
Meadows WR, Draur RA, Osadjan CE (1971) Dicrotism in heart disease. Am Heart J 82:596–608
Orchard RC, Craige E (1980) Dicrotic pulse after open heart surgery. Circulation 62:1107–1114
O’Rourke MF, Pauca A, Jiang XJ (2001) Pulse wave analysis. Br J Clin Pharmacol 51:507–522
Schwid HA, Taylor LA, Smith NT (1987) Computer model analysis of the radial artery pressure waveform. J Clin Monit 3:220–228
Smith D, Craige E (1986) Mechanism of the dicrotic pulse. Br Heart J 56:531–534
Wemple RR (1972) Origin of the dicrotic notch and wave. Biomed Sci Instrum 9:45–47
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Barber, B.J., Donnerstein, R., Secomb, T. et al. The Dicrotic Pulse: A Common, Non-Ominous Finding After the Ross Operation. Pediatr Cardiol 28, 247–249 (2007). https://doi.org/10.1007/s00246-006-0005-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-006-0005-4