TY - JOUR
T1 - Right ventricular dysfunction in low output syndrome after cardiac operations
T2 - Assessment by transesophageal echocardiography
AU - Dávila-Román, Victor G.
AU - Waggoner, Alan D.
AU - Hopkins, William E.
AU - Barzilai, Benico
N1 - Funding Information:
This work was supported in part during the tenure of a Minority Scientist Development Award from the American tleart Association and by the National Institutes of Health HL-17646 (SCOR in Coronary and Vascular Diseases) Minorit\ Investigator Research Grant (MIRS), both to Dr Davila-Rom~in.
PY - 1995/10
Y1 - 1995/10
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0028882286&partnerID=8YFLogxK
U2 - 10.1016/0003-4975(95)00526-Q
DO - 10.1016/0003-4975(95)00526-Q
M3 - Article
C2 - 7574953
AN - SCOPUS:0028882286
SN - 0003-4975
VL - 60
SP - 1081
EP - 1086
JO - The Annals of thoracic surgery
JF - The Annals of thoracic surgery
IS - 4
ER -