scholarly journals A Case of Emergency Surgery for a Huge Primary Right Atrial Angiosarcoma with Right Ventricular Failure and Shock

2011 ◽  
Vol 40 (6) ◽  
pp. 322-325
Author(s):  
Yuji Kato ◽  
Masanori Kato ◽  
Mitsuhisa Kotani ◽  
Kazuhiro Hisamoto ◽  
Yukiharu Sugimura ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Emergency Surgery ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Ventricular Failure

Usefulness of regional right ventricular and right atrial strain for prediction of early and late right ventricular failure following a left ventricular assist device implant: A machine learning approach

2019 ◽  
Vol 43 (5) ◽  
pp. 297-314 ◽  
Author(s):  
Diego Bellavia ◽  
Attilio Iacovoni ◽  
Valentina Agnese ◽  
Calogero Falletta ◽  
Claudia Coronnello ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Assist Device ◽  
Left Ventricular ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Ventricular Failure ◽  
Left Ventricular Assist ◽  
Acute Right Ventricular Failure ◽  
Right Atrial Strain ◽  
Atrial Strain

Background: Identifying candidates for left ventricular assist device surgery at risk of right ventricular failure remains difficult. The aim was to identify the most accurate predictors of right ventricular failure among clinical, biological, and imaging markers, assessed by agreement of different supervised machine learning algorithms. Methods: Seventy-four patients, referred to HeartWare left ventricular assist device since 2010 in two Italian centers, were recruited. Biomarkers, right ventricular standard, and strain echocardiography, as well as cath-lab measures, were compared among patients who did not develop right ventricular failure (N = 56), those with acute–right ventricular failure (N = 8, 11%) or chronic–right ventricular failure (N = 10, 14%). Logistic regression, penalized logistic regression, linear support vector machines, and naïve Bayes algorithms with leave-one-out validation were used to evaluate the efficiency of any combination of three collected variables in an “all-subsets” approach. Results: Michigan risk score combined with central venous pressure assessed invasively and apical longitudinal systolic strain of the right ventricular–free wall were the most significant predictors of acute–right ventricular failure (maximum receiver operating characteristic–area under the curve = 0.95, 95% confidence interval = 0.91–1.00, by the naïve Bayes), while the right ventricular–free wall systolic strain of the middle segment, right atrial strain (QRS-synced), and tricuspid annular plane systolic excursion were the most significant predictors of Chronic-RVF (receiver operating characteristic–area under the curve = 0.97, 95% confidence interval = 0.91–1.00, according to naïve Bayes). Conclusion: Apical right ventricular strain as well as right atrial strain provides complementary information, both critical to predict acute–right ventricular failure and chronic–right ventricular failure, respectively.

Mechanisms of hypotension produced by platelet-activating factor

1989 ◽  
Vol 66 (6) ◽  
pp. 2681-2690 ◽  
Author(s):  
F. R. Laurindo ◽  
R. E. Goldstein ◽  
N. J. Davenport ◽  
D. Ezra ◽  
G. Z. Feuerstein
Keyword(s):  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Ventricular Dysfunction ◽  
Platelet Activating Factor ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Ventricular Failure

Platelet-activating factor (PAF) is a phospholipid mediator that induces cardiovascular collapse and release of the secondary mediator thromboxane A2 (TxA2). To clarify mechanisms involved in this collapse and, specifically, the relative contribution of left ventricular and right ventricular dysfunction, we studied 12 open-chest pigs. PAF infusion (0.04–0.28 nmol.kg-1.min-1) induced a 5- to 120-fold increase in pulmonary vascular resistance, a 75–98% fall in cardiac output, and systemic arterial hypotension. Right ventricular failure was indicated by chamber enlargement, decreased shortening, and increased right atrial pressures. In contrast, left ventricular dysfunction was accompanied by decreases in chamber dimensions and filling pressures that were unresponsive to volume expansion. U 46619 (a stable TxA2 analogue) and mechanical pulmonary artery constriction induced changes similar to PAF. In 11 additional closed-chest pigs, TxA2 blockade with indomethacin attenuated the PAF-induced rise in pulmonary vascular resistance, right ventricular dysfunction, and systemic hypotension. A specific TxA2 synthase inhibitor, OKY-046, also diminished hemodynamic effects of PAF in six other pigs. Tachyphylaxis was not observed in five pigs repeatedly given PAF. We conclude that acute right ventricular failure as the result of severe increase in pulmonary vascular resistance is the primary mechanism early in the course of PAF-induced shock in the pig. PAF-induced release of TxA2 may contribute significantly to these events.

Abstract 19195: Pulmonary Artery Pulsatility Index Predicts Right Ventricular Failure Following LVAD Surgery

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kevin J Morine ◽  
Michael S Kiernan ◽  
Duc T Pham ◽  
David Denofrio ◽  
Navin K Kapur
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Pulsatility Index ◽  
Right Ventricular Failure ◽  
Right Atrial ◽  
Systolic Pulmonary Artery Pressure ◽  
Stroke Work ◽  
Ventricular Failure ◽  
Artery Pressure

Introduction: Identification of pre-operative right ventricular dysfunction may improve patient selection for isolated LVAD surgery. The pulmonary artery pulsatility index (PaPi) is a recently described hemodynamic metric. We evaluated baseline PaPi as a predictor of post-operative right ventricular failure (RVF) following LVAD surgery. Methods: We conducted a retrospective review of 132 consecutive LVAD implantations at our hospital. Demographic, clinical, hemodynamic and echocardiographic data were evaluated for their association with the development of RVF. RVF was defined as need for RVAD or inotrope dependence for greater than 14 days. PaPi was calculated as [(systolic pulmonary artery pressure-diastolic pulmonary artery pressure)/right atrial (RA) pressure]. Univariate analysis was performed to identify baseline predictors of RVF. Multivariate logistic regression was used to adjust for baseline RA pressure. Results: RVF occurred in 31 of 132 patients (23%); all cases were due to prolonged inotropes. PaPi was lower among patients with RVF compared to those without (no RVF: mean 2.75± SD1.17 vs RVF: 1.38±0.46, P<0.0001). RA pressure, RA to pulmonary capillary wedge pressure ratio (RA/PCWP) and RV stroke work index (RVSWI) were also associated with RVF. Previously identified markers of RV function including mean pulmonary artery pressure and qualitative RV dysfunction by 2D echo were not associated with RVF. Comparison of the area under the curve from receiver operator characteristic curve analysis demonstrated that a PaPi<1.85 was most predictive of RVF (Figure). PaPi remained an independent predictor of RVF after adjusting for RA pressure in a multivariate model. Conclusions: PaPi is a routinely available and easily calculated hemodynamic variable associated with RVF following LVAD surgery superior to established markers. Further evaluation of PaPi as part of a risk prediction model to guide clinical decision making may be warranted.

577 Myocardial effects of Ghrelin and expression of its receptors in the progression to right ventricular failure

2003 ◽  
Vol 2 (1) ◽  
pp. 125
Author(s):  
A LOURENCO ◽  
P CASTROCHAVES ◽  
J SOARES ◽  
R MIGUELOTE ◽  
R RONCONALBUQUERQUE ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Failure ◽  
Ventricular Failure
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