Right Ventricular Dysfunction and Short-Term Outcomes Following Left-Sided Valvular Surgery: An Echocardiographic Study.

Content Provider	Europe PMC
Author	Towheed, Arooge Sabbagh, Ebrahim Gupta, Rajesh Assiri, Salem Chowdhury, Mohammed A. Moukarbel, George V. Khuder, Sadik A. Schwann, Thomas A. Bonnell, Mark R. Cooper, Christopher J. Khouri, Samer
Abstract	BackgroundThe prognostic value of echocardiographic evaluation of right ventricular (RV) function in patients undergoing left‐sided valvular surgery has not been well described. The objective of this study is to determine the role of broad echocardiographic assessment of RV function in predicting short‐term outcomes after valvular surgery.Methods and ResultsPreoperative echocardiographic data, perioperative adverse outcomes, and 30‐day mortality were analyzed in patients who underwent left‐sided valvular surgery from 2006 to 2014. Echocardiographic parameters used to evaluate RV function include RV fractional area change, tricuspid annular plane systolic excursion, systolic movement of the RV lateral wall using tissue Doppler imaging (S'), RV myocardial performance index, and RV dP/dt. Subjects with at least 3 abnormal parameters out of the 5 aforementioned indices were defined as having significant RV dysfunction. The study included 269 patients with valvular surgery (average age: 67±15, 60.6% male, 148 aortic, and 121 mitral). RV dysfunction was found in 53 (19.7%) patients; 30‐day mortality occurred in 20 patients (7.5%). Compared with normal RV function, patients with RV dysfunction had higher 30‐day mortality (22.6% versus 3.8%; P=0.01) and were at risk for developing multisystem failure/shock (13.2% versus 3.2%; P=0.01). Multivariate analyses showed that preexisting RV dysfunction was the strongest predictor of increased 30‐day mortality (odds ratio: 3.5; 95% CI, 1.1–11.1; P<0.05).ConclusionsPreoperative RV dysfunction identified by comprehensive echocardiographic assessment is a strong predictor of adverse outcomes following left‐sided valvular surgery.
Page Count	11
Journal	Journal of the American Heart Association
Volume Number	10
PubMed Central reference number	PMC7955341
Issue Number	4
PubMed reference number	33559474
e-ISSN	20479980
DOI	10.1161/jaha.120.016283
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2021-02-09
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Subject Keyword	echocardiography right ventricle valvular surgery Echocardiography Prognosis
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine