Right Ventricular Function is Reduced During Cardiac Surgery Independent of Procedural Characteristics, Reoperative Status, or Pericardiotomy

Monday, April 29, 2019

Submitted by

Arie Blitz

Source

Source Name: The Journal of Thoracic and Cardiovascular Surgery

Source URL: https://doi.org/10.1016/j.jtcvs.2019.04.035

Author(s)

Asha Singh, Xiaojie Huang, Lu Dai, Daniel Wyler, Andrej Alfirevic, Eugene H. Blackstone, Gosta B. Pettersson, Andra E. Duncan

The authors prospectively analyzed right ventricular (RV) function in 109 patients undergoing a broad range of cardiac surgeries. RV function was assessed at several time points by evaluating TAPSE and 2D longitudinal RV strain to evaluate long axis RV function, and fractional area exchange to evaluate global RV function. After CPB and after chest closure, reduced RV function was demonstrated across all cardiac procedures. Thus, there is a significant failure to protect the RV during surgery.

If one accepts these findings, what modes of myocardial protection should be assessed or re-assessed to protect the RV? Why or why not?

Comments

Submitted by Frank Rosell on Wed, 2019-05-01 18:00

Interesting, try including or comparing a cohort of off-pump CABG patients...although I see the RV function fluctuate during OPCAB, can't imagine the RV function remains depressed by the end of the surgery....though we don't routinely measure TAPSE, or 2D longitudinal RV strain...