Document Detail


Right ventricular dysfunction in low output syndrome after cardiac operations: assessment by transesophageal echocardiography.
MedLine Citation:
PMID:  7574953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
V G D?vila-Rom?n; A D Waggoner; W E Hopkins; B Barzilai
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  60     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-08     Completed Date:  1995-11-08     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1081-6     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiac Output, Low / complications,  physiopathology*
Cardiac Surgical Procedures*
Coronary Angiography
Echocardiography, Transesophageal*
Female
Hemodynamics
Humans
Male
Middle Aged
Postoperative Complications / physiopathology,  ultrasonography*
Ventricular Dysfunction, Left / physiopathology,  ultrasonography
Ventricular Dysfunction, Right / etiology,  mortality,  physiopathology,  ultrasonography*
Grant Support
ID/Acronym/Agency:
HL-17646/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Ann Thorac Surg. 1996 Jul;62(1):319   [PMID:  8678677 ]

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