Is there dominance of free wall radial motion in global right ventricular function in heart transplant recipients or in all heart surgery patients?

2018 ◽  
Vol 32 (7) ◽  
pp. e13282
Author(s):  
Juan Betuel Ivey-Miranda ◽  
Marta Farrero-Torres
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Heart Transplant ◽  
Right Ventricular Function ◽  
Heart Surgery ◽  
Radial Motion ◽  
Free Wall ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

scholarly journals Dominance of free wall radial motion in global right ventricular function of heart transplant recipients

2018 ◽  
Vol 32 (3) ◽  
pp. e13192 ◽  
Author(s):  
Bálint Károly Lakatos ◽  
Márton Tokodi ◽  
Alexandra Assabiny ◽  
Zoltán Tősér ◽  
Annamária Kosztin ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Heart Transplant ◽  
Right Ventricular Function ◽  
Radial Motion ◽  
Free Wall ◽  
Transplant Recipients ◽  
Heart Transplant Recipients

P1678Feasibility of comprehensive multi-plane echocardiographic evaluation of right ventricular function pre-LVAD implantation - preliminary results from a single centre experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D J Bowen ◽  
Y C Yalcin ◽  
M Strachinaru ◽  
J S McGhie ◽  
A E Van Den Bosch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Advanced Heart Failure ◽  
Free Wall ◽  
Heart Failure Patients ◽  
Echocardiographic Evaluation ◽  
The Right

Abstract Introduction Right sided heart failure (RVF) is recognized as a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite the publication of several risk scores and predication models, identifying patients at risk for RVF after LVAD implantation remains a challenge. The right ventricle is complex in structure and not possible to fully assess from one echocardiographic 2D plane. Our centre previously introduced a novel multi-plane approach whereby four different RV free wall segments (lateral, anterior, inferior and inferior coronal – figure 1) can be imaged from the same echocardiographic position using electronic plane rotation. Purpose The aim of the study was to determine the feasibility of using multi-plane echocardiography to quantify right ventricular function in a small cohort of advanced heart failure patients prior to LVAD implantation. Methods Twelve advanced heart failure patients underwent detailed RV assessment by multi-plane echocardiography prior to LVAD implantation (median -15 [6.3–29.8] days before). Feasibility and values of the established RV functional echo parameters tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler imaging derived tricuspid annular peak systolic velocity (TDI S') were assessed by an experienced sonographer on each of the 4 free wall segments. Mean values were calculated from an average of 3 measurements. Conventional 2D echo parameters and clinical outcome data post LVAD implantation were also collected. Results Feasibility of TAPSE and TDI measurements in all four RV free wall segments was 100%, with the exception of the inferior coronal wall (91.7% – TDI S' only). Mean 4 wall averaged TAPSE was 13.9±5.1mm, whilst mean TDI S' was 9.4±2.6cm/s. Mean TAPSE and TDI values were lower in the inferior and inferior coronal walls (13.3±5.8mm; 8.8±3.1cm/s and 10.9±5.7mm; 8.9±3.7cm/s) than those of the lateral and anterior walls (15.6±5.1mm; 9.9±2.3cm/s and 15.9±5.1mm; 10.1±2.6cm/s). The cohort was split by using a four wall averaged TAPSE value of 16mm as a cutoff. Mean 4 wall averaged TAPSE was 20.6±1.9mm in the >16mm group compared to 10.5±1.7mm for the <16mm group, whilst mean TDI S' was 9.4±2.6cm/s vs 7.7±0.7cm/s. Post LVAD implantation, there were 3 (25%) deaths and 6 (50%) incidences of acute kidney injury. Median length of stay in ICU and hospital was 4 (1–13.5) and 42.5 (30.3–65) days respectively. The <16mm group had higher incidences of negative outcomes and longer stay in both ICU and hospital following LVAD implantation (p: 0.07). Conclusion Multi-plane echocardiographic evaluation of the right ventricle appears feasible in advanced heart failure with potential for a more comprehensive quantification of right ventricular function pre-LVAD implantation. Larger, ideally multi-centre studies are required to further assess these preliminary findings.

scholarly journals Adding tricuspid repair to standard open heart surgery does not increase risk but improves right ventricular function

2019 ◽  
Vol 29 (3) ◽  
pp. 416-421 ◽  
Author(s):  
Clarence Pingpoh ◽  
Sarah Nuss ◽  
Sami Kueri ◽  
Maximillian Kreibich ◽  
Martin Czerny ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Group 2 ◽  
Repair Group ◽  
Tricuspid Repair ◽  
Group 1

Abstract OBJECTIVES To evaluate outcome of concomitant tricuspid annuloplasty in mild or moderate regurgitation on perioperative outcome and on right ventricular function in patients undergoing major cardiac surgery. METHODS Among 14 500 patients who underwent cardiac surgery at our institution between January 2000 and April 2016, 1023 patients had a documented history of tricuspid regurgitation (TR). Of those patients, 324 patients were diagnosed with mild or moderate secondary TR with a dilated annulus (≥40 mm or >21 mm/m2) and composed the study population. The decision to perform concomitant annuloplasty was subjected to the individual decision of the treating surgeon. Our analysis focused on a comparison between patients with concomitant TR-repair (group 1, n = 184) and patients without concomitant TR-repair (group 2, n = 140) after propensity score matching. RESULTS Following a preliminary data preprocessing, we observed a mean age of 73.8 years, mean logistic EuroSCORE of 10.5%. Perioperative mortality was 4.4% in group 1 and 5.7% in group 2. There was no significant difference in mid-term mortality. TR after surgery was significantly higher in group 2. After propensity score matching regression analysis, patients who had a repaired tricuspid valve (group 1) had better right ventricle (RV) function than those without TR-repair (group 2) (P > 0.05 at 95% confidence interval following Kolmogorov–Smirnov Goodness of fit Test). CONCLUSIONS Adding tricuspid valve repair in patients with mild or moderate secondary TR with a dilated annulus (≥40 mm or >21 mm/m2) to standard open heart surgery does not increase perioperative risk but improves right ventricular function. Therefore, standard tricuspid repair in this subgroup might be considered on a routine basis.

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