Left-ventricular diastolic dysfunction during pneumonectomy--a transesophageal echocardiographic study

Area of Science:

• Cardiology
• Thoracic Surgery
• Echocardiography

Background:

• Pneumonectomy can lead to acute increases in pulmonary capillary pressure.
• Left-ventricular dysfunction may unexpectedly develop post-pneumonectomy.
• Morphofunctional cardiac changes after pneumonectomy require investigation.

Purpose of the Study:

• To investigate the morphofunctional modifications in left cardiac chambers after pneumonectomy.
• To assess the impact of pneumonectomy on interventricular septum geometry and left ventricular function.
• To identify transient cardiac changes induced by pneumonectomy.

Main Methods:

• Intraoperative transesophageal echocardiography (TEE) in 8 patients undergoing pneumonectomy.
• Analysis of interventricular septum movement and geometry.
• Evaluation of pulmonary vein flow-profile and mitral regurgitation using Doppler and color Doppler.

Main Results:

• Pneumonectomy induced rectilinear changes in the interventricular septum geometry, linked to increased right-ventricular dimensions.
• Pulmonary vein flow showed increased turbulence, with altered systolic components and mild mitral regurgitation.
• These echocardiographic changes were transient and resolved before chest closure.
• No significant alteration in left-ventricular systolic function was observed.

Conclusions:

• Acute right-ventricular overload following pneumonectomy alters interventricular septum geometry.
• This geometric change induces transient left-ventricular diastolic dysfunction and mild mitral regurgitation.
• These cardiac effects are temporary and reversible after pneumonectomy.