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Effect of pulmonary resection on right ventricular function.

C E Reed1, F G Spinale, F A Crawford

  • 1Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425.

The Annals of Thoracic Surgery
|April 11, 1992
PubMed
Summary
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Pulmonary resection significantly impairs right ventricular (RV) function post-surgery, with increased RV volume and decreased RV ejection fraction. This RV dysfunction may contribute to patient outcomes after lung surgery.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • The impact of pulmonary resection on right ventricular (RV) function is not well understood.
  • Assessing RV performance is crucial for understanding post-surgical morbidity and mortality.

Purpose of the Study:

  • To evaluate RV performance using advanced thermodilution techniques during and after major pulmonary resection.
  • To identify changes in RV end-diastolic volume and RV ejection fraction following lung surgery.

Main Methods:

  • Utilized thermodilution methods with a fast-response thermistor in the pulmonary artery.
  • Measured RV end-diastolic volume and RV ejection fraction in 15 patients undergoing pulmonary resection.
  • Monitored RV performance preoperatively, early postoperatively, and on postoperative days 1 and 2.

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Main Results:

  • Demonstrated significant RV dysfunction in the postoperative period.
  • Right ventricular end-diastolic volume increased significantly on postoperative days 1 and 2 compared to early postoperatively (p < 0.05).
  • RV ejection fraction significantly decreased by postoperative day 2 from preoperative and early postoperative values (p < 0.05).
  • Pulmonary artery pressures and pulmonary vascular resistance showed modest increases but remained near baseline.

Conclusions:

  • Pulmonary resection leads to significant right ventricular dysfunction in the early postoperative period.
  • The etiology of RV dysfunction may be multifactorial, potentially involving changes in RV afterload or contractility.
  • Further investigation is needed to clarify the specific mechanisms and clinical implications of RV dysfunction after pulmonary resection.