Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery

Figures

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  Fig. 1. Schematic study overview. A comprehensive display of the study’s design, the investigated cohorts and the methodology. All patients underwent intraoperative transesophageal echocardiography (TEE) after the induction of general anesthesia but prior to sternotomy. Three-dimensional (3D) speckle-tracking-derived characterization of the right ventricle (RV) was performed using the ReVISION method. Together with left ventricular, clinical and surgical data, these parameters were tested for their association with a composite endpoint of adverse postoperative outcomes. Finally, the retrospectively derived observations were validated in prospectively enrolled patients.

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  Fig. 2. Three-dimensional echocardiographic analysis of the right ventricular mechanical pattern. Mesh models of the right ventricle (RV) derived from transesophageal three-dimensional speckle-tracking echocardiography underwent postprocessing using the ReVISION method. A representative patient from the prospective cohort experiencing adverse postoperative outcomes (left) shows severely reduced RV function compared to a patient from the same cohort with an uneventful postoperative course (right). (Top row: anterior views of the RV, bottom row: basal views of the RV)

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  Fig. 3. Receiver operating characteristic curve of right ventricular global longitudinal strain (RV GLS). Receiver operating characteristic analysis of RV GLS was performed in the retrospective patient cohort using the composite endpoint of adverse postoperative events. The optimal cutoff value was calculated at -17.4%. AUC = area under the curve.