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Decreased right ventricular function after coronary artery bypass grafting

Farideh Roshanali1, Mohammad Ali Yousefnia, Mohammad Hossein Mandegar

  • 1Day General Hospital, Tehran 14666, Iran. farideh_roshanali@yahoo.com

Texas Heart Institute Journal
|October 23, 2008
PubMed

Insights

Right ventricular function significantly decreases one year after coronary artery bypass grafting (CABG). This decline, measured by echocardiography, persists and may involve interventricular septum adaptation.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Right ventricular (RV) dysfunction is a known complication post-coronary artery bypass grafting (CABG).
  • The precise mechanisms and long-term impact on RV function remain incompletely understood.

Purpose of the Study:

  • To prospectively evaluate RV function using echocardiography before and after CABG.
  • To assess the influence of right coronary artery disease and revascularization on post-CABG RV function and interventricular septal motion.

Main Methods:

  • Prospective echocardiographic evaluation of 250 CABG candidates, with 240 completing 1-year follow-up.
  • Assessment of RV function via tricuspid annular motion, annular velocity, and free-wall strain.
  • Analysis of interventricular septal motion patterns.

Main Results:

  • Significant reductions in tricuspid annular motion (21.7 vs 12.1 mm), tissue velocity (14.0 vs 7.0 cm/s), and RV strain (20.3% vs 11.6%) were observed 1 year post-CABG (P < 0.001 for all).
  • Paradoxical interventricular septal motion was present in 97% of patients at 1 year.
  • RV dysfunction persisted at 1 year, irrespective of right coronary artery status or graft patency.

Conclusions:

  • Right ventricular function remains depressed up to one year following coronary artery bypass grafting.
  • Interventricular septal recruitment is a likely compensatory mechanism to maintain RV stroke volume post-CABG.

Keywords:
Coronary artery bypass/adverse effectsechocardiography, Dopplerechocardiography, transesophagealprospective studiestricuspid valve/ultrasonographyventricular dysfunction, right/diagnosis/ultrasonography

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