[The right ventricle in cardiac surgery: the surgeon perspective]

Right ventricular function is acknowledged as an important prognostic element in cardiovascular diseases and cardiac surgery. Although recent years have seen significant advances in the exploration of cardiac function, assessing right ventricular performance still remains a challenge for the daily practice. The right ventricle is a complex structure that cannot be approximated by a simple geometric form. It functions in a low impedance system therefore it is sensitive to pressure overload. Along with contractility and loading conditions, ventricular interactions play an important part in right ventricular function and failure. The aims of our review are to describe the main characteristics of RV anatomy, function and failure and also to present a perioperative perspective on right ventricular dysfunction assessment, its clinical significance and its urgent management. Moreover, the advantages of an early diagnosis and preventive approach will be discussed. An improved understanding of pathophysiology and technologic progress provides us with new pathways in the diagnosis and hemodynamic support of these often critically ill patients.