Right ventricular function in the surgical patient

Raper, Raymond F.; Sibbald, William J.

doi:10.1007/bf01656397

Cited by 14 publications

(4 citation statements)

References 51 publications

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“…These studies linked the changes to positive pressure ventilation, cardiopulmonary bypass, systemic inflammation, and increased pulmonary bed vasoconstriction by vasoactive drugs. [23][24][25] These factors are unlikely to be causative in the present findings because they mediate RV dysfunction through cavity dilation, not reduction as we demonstrated. In addition, several studies have demonstrated normalization of pulmonary vascular resistance by 48 hours after surgery, 24,25 and therefore, this would be unlikely to affect RV function 6 days after surgery.…”

Section: Effects Of Cabg On Rv Functionmentioning

confidence: 49%

Effects of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting on Early and Late Right Ventricular Function

et al. 2008

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Background-Off-pump CABG (OPCABG) results in better preservation of left ventricular function in the perioperative period than conventional on-pump CABG (ONCABG); however, evidence is conflicting as to the effect of OPCABG and ONCABG on right ventricular (RV) function, possibly because of the complexity involved in measuring this. Methods and Results-In a single-center randomized pilot study, 60 patients with normal left ventricular function undergoing CABG were randomly assigned to OPCABG or ONCABG. Patients underwent cardiac magnetic resonance imagine for assessment of RV function preoperatively, early postoperatively, and at 6 months after surgery. Fifty-one patients completed the first 2 scans, and 47 completed all 3 scans. Preoperative characteristics and RV function did not differ significantly between the 2 groups (meanϮSD): RV stroke volume index was 49Ϯ10 mL/m 2 for OPCABG and 49Ϯ16 mL/m 2 for ONCABG. After surgery, RV stroke volume index fell to 36Ϯ7 mL/m 2 in the OPCABG group and 39Ϯ11 mL/m 2 in the ONCABG group, but this did not differ significantly between the 2 groups (Pϭ0.41). All markers of RV function recovered to preoperative levels by 6 months, with no long-term difference between the surgical techniques. Conclusions-RV function is impaired early after surgery but recovers by 6 months. The changes were similar in both the OPCABG and ONCABG groups.

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Section: Effects Of Cabg On Rv Functionmentioning

confidence: 49%

Effects of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting on Early and Late Right Ventricular Function

et al. 2008

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“…In recent years, attention has been focused on the RV function and its association with morbidity and mortality. The RV is affected by changes in afterload, preload, and contractility [ 12 , 13 ]. In surgical patients, some consideration of RV function is warranted as many surgically relevant disease states may potentially alter such determinants of RV function [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Reduced Right Ventricular Function Predicts Long-Term Cardiac Re-Hospitalization after Cardiac Surgery

et al. 2015

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BackgroundThe significance of right ventricular ejection fraction (RVEF), independent of left ventricular ejection fraction (LVEF), following isolated coronary artery bypass grafting (CABG) and valve procedures remains unknown. The aim of this study is to examine the significance of abnormal RVEF by cardiac magnetic resonance (CMR), independent of LVEF in predicting outcomes of patients undergoing isolated CABG and valve surgery.MethodsFrom 2007 to 2009, 109 consecutive patients (mean age, 66 years; 38% female) were referred for pre-operative CMR. Abnormal RVEF and LVEF were considered <35% and <45%, respectively. Elective primary procedures include CABG (56%) and valve (44%). Thirty-day outcomes were perioperative complications, length of stay, cardiac re-hospitalizations and early mortaility; long-term (> 30 days) outcomes included, cardiac re-hospitalization, worsening congestive heart failure and mortality. Mean clinical follow up was 14 months.FindingsForty-eight patients had reduced RVEF (mean 25%) and 61 patients had normal RVEF (mean 50%) (p<0.001). Fifty-four patients had reduced LVEF (mean 30%) and 55 patients had normal LVEF (mean 59%) (p<0.001). Patients with reduced RVEF had a higher incidence of long-term cardiac re-hospitalization vs. patients with normal RVEF (31% vs.13%, p<0.05). Abnormal RVEF was a predictor for long-term cardiac re-hospitalization (HR 3.01 [CI 1.5-7.9], p<0.03). Reduced LVEF did not influence long-term cardiac re-hospitalization.ConclusionAbnormal RVEF is a stronger predictor for long-term cardiac re-hospitalization than abnormal LVEF in patients undergoing isolated CABG and valve procedures.

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“…Scveral authors have proposed that when ARDS is complicated by elevation of pulmonary vascular resistance (PVR) , ventricular contractility is compromised and the patients' prognosis deteriorates [36] .…”

Section: Lntroductionmentioning

confidence: 99%

A new experimental model of ARDS and pulmonary hypertension in the dog

Zwißler

Forst²,

Meßmer

1989

Res. Exp. Med.

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Summary. The aim of (his study was to establish a stable and reproducible model of pulmonary artery hypertension with concomitant A RDS-Iike changes o f lung fun ction and lung morphology. In eight anesthetized and ventilated dogs, 0.01 mVkg oleic acid (OA) was given i. v. fo llowed by repetitive injections of 100 J1m glass beads (OB) ioto the right atrium until a mean pulmonary artery pressure of 35~40 mm Hg was reached. Mean fight ventricular (R VP) and pulmonary artery (PA P) pressures, pulmonary vascular resistance (PVR), lung compliance and resistance, Pa0 2, intrapulmonary shunt and colloidosmotic pressure (COP) were c10sely mo nitored for 150min . PAP, RVP, and PVR considerably inereased subsequent 10 O Al GB injection, and slabilized at a high level within 70min , showing only a minimal decrease (PAP, RVP) ur no change (PVR) during the following 8O min . A signifieant decrease of Pa02 and pulmonary eomplianee as weil as an inerease o f resistance and intrapulmonary shunt were found as early as 30 min after the last embolization and they remained unchanged for 120 min . Reduction of COP suggested transcapiUary leakage of maeromoleeules. Histology revealed an interstitial and intraalveolar edema. We conclude that the eombined injeetion of oleie aeid and glass beads provokes microvascul ar Jung injury and results in stable pulmo nary artery hypertensio n wirh concomitant ARDS-like ehanges of lung funetion. Thus, an aeute mode l is provided in the dog allowing for the study of eardiac funetion in ARDS complicated by pulmo nary artery hypertension.

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Right ventricular function in the surgical patient

Cited by 14 publications

References 51 publications

Effects of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting on Early and Late Right Ventricular Function

Effects of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting on Early and Late Right Ventricular Function

Reduced Right Ventricular Function Predicts Long-Term Cardiac Re-Hospitalization after Cardiac Surgery

A new experimental model of ARDS and pulmonary hypertension in the dog

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