OBJECTIVES: Right ventricular (RV) failure after cardiac surgery is a clinical entity with high morbidity and mortality. Patients with congenital heart disease (CHD) often undergo right-sided cardiac surgery. The authors aimed to identify determinants of RV failure after cardiac surgery to differentiate patients with increased risk. DESIGN: A retrospective chart review. SETTING: University hospital. PARTICIPANTS: Adults with CHD operated on between January 2001 and January 2011. INTERVENTIONS: Clinical characteristics, laboratory tests, surgical data, and intensive care unit outcome were obtained from medical records. MEASUREMENTS AND MAIN RESULTS: The diagnosis of clinical RV failure was made by careful review of the medical records by 2 independent physicians. Patients only were identified as having RV failure if (1) they had elevated jugular venous pressure, (2) they had impaired postoperative RV function on transthoracic echocardiography, and (3) a diagnosis of RV failure was documented clearly in the medical charts by the treating physician. Data of 412 consecutive patients (median age 36 [range 18-74] years, 56% male) were studied. Eighteen patients had clinical RV failure (4.4%) postoperatively, of whom 6 patients died. Patients undergoing left- and both-sided surgery had an equal risk of developing clinical RV failure as compared with patients undergoing right-sided surgery. In multivariate logistic regression analysis, preoperative impaired RV function, supraventricular tachycardia, and cardiopulmonary bypass time >150 minutes were the strongest determinants of clinical RV failure (p<0.05, for all). CONCLUSIONS: RV failure after cardiac surgery is a serious complication, and occurs regardless of the side of surgery. A tailored approach in patients with CHD at highest risk of RV failure should be considered.
OBJECTIVES: Right ventricular (RV) failure after cardiac surgery is a clinical entity with high morbidity and mortality. Patients with congenital heart disease (CHD) often undergo right-sided cardiac surgery. The authors aimed to identify determinants of RV failure after cardiac surgery to differentiate patients with increased risk. DESIGN: A retrospective chart review. SETTING: University hospital. PARTICIPANTS: Adults with CHD operated on between January 2001 and January 2011. INTERVENTIONS: Clinical characteristics, laboratory tests, surgical data, and intensive care unit outcome were obtained from medical records. MEASUREMENTS AND MAIN RESULTS: The diagnosis of clinical RV failure was made by careful review of the medical records by 2 independent physicians. Patients only were identified as having RV failure if (1) they had elevated jugular venous pressure, (2) they had impaired postoperative RV function on transthoracic echocardiography, and (3) a diagnosis of RV failure was documented clearly in the medical charts by the treating physician. Data of 412 consecutive patients (median age 36 [range 18-74] years, 56% male) were studied. Eighteen patients had clinical RV failure (4.4%) postoperatively, of whom 6 patients died. Patients undergoing left- and both-sided surgery had an equal risk of developing clinical RV failure as compared with patients undergoing right-sided surgery. In multivariate logistic regression analysis, preoperative impaired RV function, supraventricular tachycardia, and cardiopulmonary bypass time >150 minutes were the strongest determinants of clinical RV failure (p<0.05, for all). CONCLUSIONS: RV failure after cardiac surgery is a serious complication, and occurs regardless of the side of surgery. A tailored approach in patients with CHD at highest risk of RV failure should be considered.
Authors: Stephen J Huang; Marek Nalos; Louise Smith; Arvind Rajamani; Anthony S McLean Journal: Intensive Care Med Date: 2018-05-22 Impact factor: 17.440
Authors: M J Schuuring; A P Backx; R Zwart; A H Veelenturf; D Robbers-Visser; M Groenink; A Abu-Hanna; N Bruining; M P Schijven; B J Mulder; B J Bouma Journal: Neth Heart J Date: 2016-11 Impact factor: 2.380
Authors: Victor H Nieto Estrada; Daniel L Molano Franco; Albert A Valencia Moreno; Jose A Rojas Gambasica; Cristian C Cortes Nunez Journal: Cardiol Res Date: 2016-12-31