Mechanism of Paradoxical Ventricular Septal Motion After Coronary Artery Bypass Grafting

The impact of preoperative right ventricular dysfunction on early hemodynamic instability after coronary artery bypass graft surgery

“…Comparing the motion of lateral mitral, IVS and lateral tricuspid at annulus, paradoxical motion of IVS was found in Group I and obviously enhanced to make up RV dysfunction. This conclusion was confirmed by other researchers [23,24]. Therefore patients with RV dysfunction could maintain hemodynamic stability before CABG surgery because of the compensation of IVS motion enhancement.…”

Effect of pericardial repair after aortic valve replacement on septal and right ventricular function

“…No convincing explanation as to why the septum reverses after bypass surgery has yet been established. Our data suggest that the reversed septal motion is likely a compensatory mechanism for the surgically induced fall in RV long axis function in order to maintain a normal stroke volume as we and others have shown [5][6][7]. It seems therefore that the septum does not choose to reverse but the right ventricle as a whole dictates that post operative septal behaviour.…”

“…None of these potential mechanisms has proved satisfactory enough to alter clinical practice in a way that could preserve RV function. Recently similar findings were interpreted using MRI, in a group of patients who underwent coronary artery bypass graft surgery, on the basis of RV adhesions as a potential mechanism for the restricted tricuspid annular motion and disturbed RV long axis function [5]. On the other hand, other studies have shown recovery of RV function after cardiopulmonary by-pass technique [6,7].…”

Postoperative Echocardiographic Reduction of Right Ventricular Function: Is Pericardial Opening Modality the Main Culprit?

“…The pathogenesis of such event is disputed and several hypotheses have been suggested, including type of cardioplegia [7], myocardial hypothermia [8], cardiopulmonary bypass [9], pericardial adhesions [10], and the simple opening of the pericardium [11]. …”