The Annals of Thoracic Surgery, Vol 46, 542-548, Copyright © 1988 by The Society of Thoracic Surgeons
Impairment in right ventricular performance after left ventricular aneurysm surgery
A Mangschau, O Geiran, K Rootwelt, B Laake and K Forfang
Department of Medicine, National Hospital of Norway, Oslo.
To study the effect of operation for left ventricular (LV) aneurysm on
right ventricular (RV) performance, we studied 50 patients before operation
with right heart catheterization, RV angiography, and radionuclide
ventriculography. Forty patients were followed up and underwent the same
investigations 10 +/- 4 months after operation. At baseline, regional RV
dysfunction was observed in 89% of the patients whereas global RV
dysfunction was present in approximately a third. After operation, no
changes in RV regional dysfunction or RV pressures were observed. However,
a significant increase in RV end-diastolic (p less than 0.03) and
end-systolic volume indices (p less than 0.02) along with a significant
decrease in resting and exercise RV ejection fractions (p less than 0.05)
was found. We were unable to demonstrate any significant relationship
between preoperative RV dysfunction and surgical outcome. We conclude that
RV dysfunction is common in patients with LV aneurysm. Current techniques
of operative intervention for this type of aneurysm seem to be followed by
RV dilatation and impairment in RV function.
