New developments in the understanding of right ventricular function in acute care

Area of Science:

• Cardiology
• Cardiac Surgery
• Critical Care Medicine

Background:

• Right ventricular dysfunction significantly impacts the perioperative course of cardiac surgery patients.
• Its incidence is linked to adverse outcomes, highlighting the need for effective monitoring.

Purpose of the Study:

• To review recent advancements in the detection and monitoring of perioperative right ventricular dysfunction.
• To discuss new evidence and techniques for managing right ventricular function in cardiac surgery.

Main Methods:

• Utilizing echocardiography and extra-cardiac flow evaluation for perioperative monitoring.
• Employing hemodynamic evaluation with pulmonary artery catheters for rapid, quantitative assessment.
• Exploring myocardial deformation imaging for identifying patients at risk of complications.

Main Results:

• Pulmonary artery catheters are supported by new evidence for use in cardiogenic shock.
• Pacing port transduction allows direct right ventricular pressure measurement, aiding function tracking and obstruction detection.
• Myocardial deformation imaging shows potential for risk stratification of postoperative complications.

Conclusions:

• Current monitoring techniques, including imaging and hemodynamic assessments, can be applied intraoperatively and postoperatively.
• Enhanced detection of right ventricular dysfunction can lead to improved treatment strategies.
• Early intervention before systemic organ dysfunction is key to improving patient outcomes.