Decreased right ventricular lateral wall velocities early after cardiac surgery

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.

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.

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).

Tissue Doppler velocities of the RV free wall are reduced significantly after cardiac surgery despite no reduction in RV fractional area change.