Table 2.
Prognostic Value of Right Ventricular Function in Cardiac Surgery (Selected Studies)
| Study | Population | Study Design | RV Dysfunction | Results |
|---|---|---|---|---|
| Reitchert et al. [65] | Unstable post-operative patients | Prospective n=60 | RVFAC < 35% | RV dysfunction associated with high mortality rates |
| Pinzani et al. [32] | Mitral and combined mitro-aortic surgery | Retrospective n=382 | Clinical definition | Post-operative RV failure is the strongest predictor of postoperative mortality |
| Cullen et al. [66] | Tetralogy of Fallot | Prospective n=35 | Restrictive RV physiology | Restrictive physiology predicts longer intensive care unit stay post repair and lower cardiac output |
| Gatzoulis et al. [67] | Tetralogy of Fallot | Prospective n=41 | Restrictive RV physiology | Restrictive physiology predicts smaller RV and better exercise tolerance |
| Kromos et al. [68] | LVAD and RV failure | Retrospective n=31 | Clinical mean RVEF = 11.8% | Preoperative clinical factors such as fever, pulmonary edema, and intraoperative blood transfusions were associated with RVAD need |
| Hosenpud et al. [69] | Heart Transplantation | Retrospective International Society for Heart & Lung transplantation n=69,205 | RV failure associated with circulatory failure | RV failure accounts for up to 20% of early deaths |
| Oehiai et al. [70] | LVAD | Retrospective n=245 | RV failure requiring RVAD | 23 patients (9%) required RVAD. The need for circulatory support, female gender, and non-ischemic etiology were predictors of RVAD need. |
| Maslow et al. [34] | CAD undergoing coronary bypass surgery with LVEF < 25% | Retrospective n=41 | RVFAC < 35% | RV dysfunction is associated with decreased long term survival |
| Therrien et al. [71] | Tetralogy of Fallot | Prospective n=17 | RV remodeling | Severe RV dilatation (RVEDV ≥ >170 ml/m2 or RVESV >85 ml/m2) associated with incomplete RV remodeling |
| Webb et al. [72, 73] | Atrial septal defect | Retrospective series | RV remodeling | Older age at repair and abnormal RV myocardial relaxation were associated with incomplete RV remodeling |
| Denault et al. [74] | Patients undergoing bypass surgery | Retrospective and prospective n=800 | Dynamic obstruction of RVOT (Gd > 25 mmHg) | Incidence: 4%, dynamic obstruction of RVOT was associated with a higher incidence of difficult weaning from bypass |
| Haddad et al.[35] | High risk valvular surgery | Prospective n=50 | RVFAC < 32% or RVMPI > 0.50 | Preoperative RV dysfunction was associated with a higher incidence of post-operative circulatory failure |
CAD: coronary artery disease, Gd: gradient, LV: left ventricular, LVAD: left ventricular assist device, RV: right ventricular, RVAD: right ventricular assist device, RVES: right ventricular end-systolic volume, RVED: right ventricular end-diastolic volume, RVEF: right ventricular ejection fraction, RVFAC: right ventricular fractional area change, RVMPI: right ventricular myocardial performance index, RVOT: right ventricular outflow tract obstruction. Based on [25].