HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): William E. Hopkins Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dávila-Román, V. G. Articles by Barzilai, B. Search for Related Content PubMed PubMed Citation Articles by Dávila-Román, V. G. Articles by Barzilai, B.

Ann Thorac Surg 1995;60:1081-1086
© 1995 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Right Ventricular Dysfunction in Low Output Syndrome After Cardiac Operations: Assessment by Transesophageal Echocardiography

Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri

Accepted for publication May 17, 1995.

Background. Low output syndrome after cardiac operations is associated with high morbidity and mortality rates. The contribution of right ventricular dysfunction to this syndrome has not been fully characterized. The purpose of this study was to evaluate the utility of transesophageal echocardiography to identify the frequency and the in-hospital mortality from right ventricular dysfunction in patients with this syndrome.

Methods. Seventy-five consecutive patients undergoing transesophageal echocardiography for low output syndrome early after cardiac operations were evaluated. The findings from transesophageal echocardiography were correlated with the type of surgical procedure, cross-clamp time, right heart hemodynamics, and coronary angiography.

Results. Right ventricular systolic dysfunction occurred in 36 patients (42%); in 17 patients it was isolated and in 19 patients it occurred in combination with left ventricular dysfunction. Postoperative right ventricular dysfunction was not uniformly associated with important right coronary artery disease or with prolonged ischemic time during cardiopulmonary bypass. Hemodynamic data were not useful to distinguish the group with postoperative right ventricular dysfunction. Patients with right ventricular dysfunction had a high (44%) in-hospital mortality rate.

Conclusions. Right ventricular dysfunction occurs frequently in patients with low output syndrome after cardiac operations and is associated with a high in-hospital mortality rate. Better understanding of the mechanisms causing postoperative right ventricular dysfunction may provide insight for preventing this complication.

This article has been cited by other articles:

				T. J. Pegg, J. B. Selvanayagam, T. D. Karamitsos, R. J. Arnold, J. M. Francis, S. Neubauer, and D. P. Taggart Effects of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting on Early and Late Right Ventricular Function Circulation, April 29, 2008; 117(17): 2202 - 2210. [Abstract] [Full Text] [PDF]

				A. Y. Denault, Y. Lamarche, P. Couture, F. Haddad, J. Lambert, J.-C. Tardif, and L. P. Perrault Inhaled milrinone: a new alternative in cardiac surgery? Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 346 - 360. [Abstract] [PDF]

				I. Michaux, M. Filipovic, K. Skarvan, S. Schneiter, R. Schumann, H.-R. Zerkowski, F. Bernet, and M. D. Seeberger Effects of on-pump versus off-pump coronary artery bypass graft surgery on right ventricular function J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1281 - 1288. [Abstract] [Full Text] [PDF]

				Y. Shi, A. Y. Denault, P. Couture, A. Butnaru, M. Carrier, and J.-C. Tardif Biventricular diastolic filling patterns after coronary artery bypass graft surgery J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1080 - 1086. [Abstract] [Full Text] [PDF]

				Y. Lamarche, O. Malo, E. Thorin, A. Denault, M. Carrier, J. Roy, and L.P. Perrault Inhaled but not intravenous milrinone prevents pulmonary endothelial dysfunction after cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 83 - 92. [Abstract] [Full Text] [PDF]

				D. Nordhaug, T. Steensrud, S. Muller, K. V. Husnes, and T. Myrmel Intraaortic Balloon Pumping Improves Hemodynamics and Right Ventricular Efficiency in Acute Ischemic Right Ventricular Failure Ann. Thorac. Surg., October 1, 2004; 78(4): 1426 - 1432. [Abstract] [Full Text] [PDF]

				S. Fortier, R.G. DeMaria, Y. Lamarche, O. Malo, A. Denault, F. Desjardins, M. Carrier, and L.P. Perrault Inhaled prostacyclin reduces cardiopulmonary bypass-induced pulmonary endothelial dysfunction via increased cyclic adenosine monophosphate levels J. Thorac. Cardiovasc. Surg., July 1, 2004; 128(1): 109 - 116. [Abstract] [Full Text] [PDF]

				C. Joffs, C. A. Walker, J. W. Hendrick, D. J. Fary, D. K. Almany, J. N. Davis, A. T. Goldberg, F. A. Crawford Jr, and F. G. Spinale Endothelin receptor subtype A blockade selectively reduces pulmonary pressure after cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 365 - 370. [Abstract] [Full Text] [PDF]

				E. A. Kopman Central Venous Pressure/Pulmonary Capillary Wedge Pressure Ratio Ann. Thorac. Surg., July 1, 1996; 62(1): 319 - 319. [Full Text]