Key result
Right ventricular contractile patterns are markedly altered after cardiac surgery, with decreased longitudinal and increased transverse shortening likely resulting from septal damage.
The review highlights that diminished longitudinal RV contraction after cardiac surgery is compensated by increased transverse shortening, emphasizing the need to monitor septal function rather than relying solely on TAPSE or S'.
RV assessment post-surgery should integrate transverse shortening; leaves open whether septal protection improves outcomes.
Assessment of right ventricular ( RV ) function is important in the management of various forms of cardiovascular disease. Accurately assessing RV volume and systolic function is a challenge in day‐to‐day clinical practice due to its complex geometry. Tricuspid annular plane systolic excursion ( TAPSE ) and systolic excursion velocity (S′) have been reviewed to further assess their suitability and objectivity in evaluating RV function. Multiple studies have validated their diagnostic and prognostic values in numerous pathologic conditions. Diminished longitudinal contraction after cardiothoracic surgery is a well‐known phenomenon, but it is not well validated. Despite significant reduction in RV performance along the long‐axis assessed by TAPSE and S′ after cardiac surgery, RV ejection fractions did not change as well as the left ventricular parameters and exercise capacity. RV contractile patterns were markedly altered with decreased longitudinal shortening and increased transverse shortening, which are likely resulted from the septal damage during cardiac surgery. The septum is essential for RV performance due to its oblique fiber orientation. This allows ventricular twisting, which is a vital mechanism against increased pulmonary vascular resistance. The septum function along with TAPSE and S′ should be adequately assessed during cardiac surgery, and evidence of septal dysfunction should lead to reevaluation of myocardial protection methods.
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Nguyen et al. (2014) conducted a review in Cardiovascular disease requiring cardiac surgery. Cardiac surgery was evaluated. Right ventricular contractile patterns are markedly altered after cardiac surgery, with decreased longitudinal and increased transverse shortening likely resulting from septal damage.
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