Key result
Cardiac surgery is linked to reduced RV lateral wall tissue Doppler velocities early postoperatively.
Why the study?
Right ventricular function is less often monitored than left ventricular function and might influence the postoperative period in patients undergoing coronary bypass or heart valve surgery.
Does cardiac surgery alter right ventricular lateral wall velocities early postoperatively in patients undergoing CABG or valvular surgery?
Observational (n=87)
Does cardiac surgery alter right ventricular lateral wall velocities early postoperatively in patients undergoing CABG or valvular surgery?
Tissue Doppler velocities of the RV free wall are significantly reduced early after cardiac surgery despite preserved RV fractional area change, indicating altered longitudinal mechanics.
RV tissue Doppler changes early after cardiac surgery; leaves open whether routine RV monitoring alters perioperative management.
BACKGROUND: Right ventricular (RV) function is less often monitored than left ventricular (LV) function and might influence the postoperative period in patients undergoing coronary bypass or heart valve surgery. Our objective was to compare RV lateral wall velocities before and soon after heart surgery. METHODS: We examined 87 patients before and at a median time of 5 days after surgery with tissue Doppler echocardiography. On-pump coronary artery bypass grafting was performed in 40 patients, and valvular surgery in 47 patients. The pulsed Doppler sample was positioned at the midportion of the RV lateral wall, on the septum and on the LV lateral wall to record peak systolic (S), early (E) and late (A) diastolic tissue Doppler velocities. RESULTS: We observed lower values of LV end diastolic volume and left atrial area (P < 0.001) but no differences in RV fractional area change as well as LV ejection fraction between before and after surgery. RV S, E, and A were dramatically lower in the postoperative group (P < 0.001 between before and after surgery), as well as septal S, E, and A (P < 0.005 between before and after). No change occurred on LV lateral S and A, whereas LV lateral wall E velocity was slightly higher in the postoperative group (P < 0.05). CONCLUSIONS: Tissue Doppler velocities of the RV free wall are reduced significantly after cardiac surgery despite no reduction in RV fractional area change.
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Larrazet et al. (2011) conducted an observational in Patients undergoing coronary bypass or heart valve surgery (n=87). Cardiac surgery vs. Before surgery (baseline) was evaluated on Right ventricular lateral wall velocities (peak systolic, early and late diastolic) (p=<0.001). Cardiac surgery significantly reduced right ventricular lateral wall peak systolic, early, and late diastolic tissue Doppler velocities at a median of 5 days postoperatively (P < 0.001).
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