Hemodynamic changes during prostatectomy in cardiac patients.

Hemodynamic responses to transurethral prostatectomy (TURP) were studied in 9 patients with severe cardiac disease. This group of patients tolerated spinal anesthesia and TURP in an unpredictable manner. One adverse effect was the high pulmonary capillary wedge pressures (WP of 21 mm Hg or higher) in 4 of the 9 patients during operation. All nine cases were considered. Attention was directed toward significant cases. The high WP was not always indicated by high CVP either before or during operation, and it did not necessarily relate to the amount of fluid utilized or amount of prostate resected. Another adverse effect was the marked changes in systemic resistance in 6 patients. Because of the unpredictable hemodynamic responses, thermodilution flow-directed pulmonary artery catheter was valuable in several cases. It made it possible to select specific therapeutic agents and direct tham at isolated hemodynamic dysfunctions.