Effect of Off-Pump Coronary Artery Bypass Graft Surgery on Transthoracic Echocardiographic Right Ventricular Function in Indian Patients

Abstract

Background: The importance of the right ventricle as a determinant of exercise capacity and its significant prognostic value in the evaluation of surgical outcomes has been largely proven. In this study, we sought to explore the effect of off-pump coronary artery bypass surgery (OPCAB) on right ventricular (RV) function by the different methods of RV functional assessment on transthoracic echocardiography. Materials and Methods: This is a prospective cohort study. All patients undergoing elective OPCAB were included in the study from July 1, 2016, to October 1, 2016 after an informed consent. Their preoperative, postoperative day 4, and postoperative 2-month transthoracic echocardiographic RV and left ventricular functions were evaluated and analyzed. Results: A total of 48 patients undergoing OPCAB were included in this study. The mean age of the cohort was 57.2 ± 8 years. About 85.4% (41) were males. Overall, there is a significant time effect observed in RV ejection fraction (RVEF), with a significant decline from preoperative to postoperative value and a significant increase from postoperative day 4 to postoperative 2-month value. Although RVEF was lower throughout the study in patients with events than those without events, this difference was not statistically significant. Conclusion: In this Indian cohort of patients undergoing OPCAB, there is a significant drop in RVEF, RV tissue Doppler, tricuspid annular peak systolic excursion on postoperative day 4, and also a significant increase in these values over the next 2 months though not reaching the basal value. Hence, suggesting that the drop in RV function is temporary and recovers over time in patients undergoing OPCAB. Patients with events had a lower RVEF when compared to those without events suggesting prognostication.

Assessment of Right Ventricular Function in Patients undergoing Coronary Artery Bypass Graft : a single center study

“…Furthermore the study of Ordienė, Unikas [32] who studied the changes of biventricular function after CABG surgery and found that the reduction was seen right after the surgery had a tendency to improve within the follow-up period (6 months) [32]. Similarly, the study of John, Thomas [33] found signi cant increase in the RV function post CABG over the next 2 months after surgery [33]. This study was against the study of Chinikar, Ra ee [34] who studied RV dysfunction correlates in patients after CABG and found that RVD remains till 6-months postoperative follow up [34].…”