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Right ventricular dysfunction after major pulmonary resection

M Okada1, T Ota, M Okada

  • 1Department of Surgery, Kobe University School of Medicine, Japan.

The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1994
PubMed
Summary
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Major pulmonary resection impairs right ventricular function, especially during exercise. Post-surgery, the right ventricle shows reduced ejection fraction and increased volume, suggesting afterload changes are key to dysfunction.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • Major pulmonary resections like lobectomy or pneumonectomy can impact cardiopulmonary hemodynamics.
  • The right ventricle's role in adapting to altered pulmonary vasculature post-surgery is not fully understood.

Purpose of the Study:

  • To assess right ventricular (RV) performance at rest and during exercise before and after major pulmonary resection.
  • To investigate the determinants of RV dysfunction following lobectomy or pneumonectomy.

Main Methods:

  • Thermodilution technique used to measure RV performance in 20 patients.
  • Measurements taken at rest and during exercise, pre- and post-operatively.

Main Results:

  • RV ejection fraction significantly decreased post-surgery, particularly during exercise.

Related Experiment Videos

  • RV end-diastolic volume index increased post-surgery, while heart rate increased to maintain cardiac output.
  • Left ventricular function remained preserved; pulmonary arterial pressure and resistance increased only during exercise.

    • Conclusions:

    • Right ventricular dysfunction after pulmonary resection is evident, especially during exercise.
    • Changes in RV afterload appear to be the primary determinant of impaired RV pump performance.
    • The RV may function as a reservoir, with its capacity compromised post-resection.