Right ventricular function in the surgical patient

It has long been appreciated that the cardiovascular system plays a vital role in surgical illnesses. Although attention has, historically, been largely focused on the left ventricle, it has become apparent in recent years that the right ventricle may contribute significantly to an absolute or relative failure of cardiovascular adaptation to acute and chronic disease states. Many of the physiological principles governing left ventricular function also determine right ventricular function. Thus, the right ventricle is affected by changes in afterload, preload, and contractility. Since many surgically relevant disease states may potentially alter such determinants of right ventricular function, some consideration of right ventricular function and its effect on global cardiac function in the surgical patient is warranted. In this review, we have attempted to provide a brief overview of normal right ventricular physiology as well as the pathophysiology and therapy of right ventricular dysfunction that may be seen in the surgical patient.