Marked changes in right ventricular contractile pattern after cardiothoracic surgery: Implications for post-surgical assessment of right ventricular function
Section snippets
Methods
We retrospectively evaluated the RV contractile pattern in normal subjects without cardiovascular disease and in subjects who underwent cardiac surgery with CPB plus pericardiotomy. The cohort included patients who had orthotopic heart transplant (OHT) and isolated coronary artery bypass (CABG) surgery. Cardiac transplant patients were included for 2 reasons: (1) by definition, these allografts were normal hearts prior to transplantation; and (2) all patients had invasive hemodynamics at 1
Patient characteristics
A total of 186 patients were included in the study, including 84 normal subjects, 54 OHT patients, 23 CABG patients and 25 OLT patients. Of the OLT patients, 14 had DLT with CPB and 11 had SLT without CPB. Baseline characteristics of the various study cohorts are presented in Table 1. Normal subjects without cardiovascular disease were significantly younger (43 ± 14 years), and the patients undergoing isolated CABG were the oldest (66 ± 11 years). However, there was no significant correlation
Discussion
In this study we found that, after cardiac surgery with CPB and complete pericardiotomy, there was a dramatic reduction in longitudinal contraction and relative increase in transverse shortening despite normal overall RV function. This pattern was similar in post-CABG and -OHT patients compared with normal subjects, resulting in a significantly lower TAPSE relative to global RV function. Patients post-OLT, who underwent CPB and pericardial incision, but did not have cardiac surgery per se,
Disclosure statement
The authors have no conflicts of interest to disclose. There was no off-label use of devices or medications in this investigation. The first 2 authors (A.R. and A.V.) contributed equally to this study.
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