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  • Title: Is Systolic Right Ventricular Function Reduced after Thoracic Non-Cardiac Surgery? A Propensity Matched Echocardiographic Analysis.
    Author: Steffen HJ, Kalverkamp S, Zayat R, Autschbach R, Spillner JW, Hagendorff A, Hatam N.
    Journal: Ann Thorac Cardiovasc Surg; 2018 Oct 19; 24(5):238-246. PubMed ID: 29877218.
    Abstract:
    PURPOSE: To assess whether thoracic non-cardiac surgery has an influence on right ventricular function (RVF) compared to known impaired postoperative RV function after cardiac surgery. METHODS: In all, 50 patients (mean age: 61 years), who underwent thoracic non-cardiac surgery were included and matched using propensity score to 50 patients, receiving coronary artery bypass graft surgery (CABG) (CABGmatched). All patients had transthoracic echocardiography (TTE) including two-dimensional speckle tracking (2D-STE) and tissue Doppler imaging (TDI) pre- and 1 week postoperatively. RESULTS: No significant changes in RV measurements including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), RV fractional area change (RV-FAC), and 2D-STE of the RV and RV freewall within the thoracic non-cardiac surgery patients comparing pre- and postoperative values. Comparing RV TTE values between CABGmatched patients and thoracic surgery patients, only TAPSE differed between groups preoperatively (p <0.0001), where postoperatively, all RV measurements differed significantly between the two groups: TAPSE (p <0.0001), TASV (p <0.001), RVFAC (p = 0.005), and RV 2D-STE (p <0.0001) indicating impairment of RV function post-CABG surgery compared to thoracic non-cardiac surgery. CONCLUSION: Thoracic non-cardiac surgery including an opening of the pleural cavity did not influence RV function early postoperative, whereas CABG surgery with pericardiotomy led to an impaired global RV function.
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