1. Limitations of right ventricular annular parameters in the early postoperative period following pulmonary endarterectomy: an observational study
- Author
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Catherine Pilorge, Myriam Amsallem, Saida Rezaiguia-Delclaux, Elie Fadel, Francois Haddad, and François Stéphan
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart Ventricles ,Diastole ,Cardiac index ,Endarterectomy ,030204 cardiovascular system & hematology ,Preoperative care ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,medicine ,Humans ,Postoperative Period ,Systole ,Lung ,business.industry ,Middle Aged ,Annular velocity ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Pulmonary artery ,Ventricular Function, Right ,cardiovascular system ,Cardiology ,Vascular resistance ,Female ,Surgery ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES Echocardiographic right ventricular (RV) annular parameters are probably not as reliable to evaluate the surgical success in the postoperative period after pulmonary endarterectomy (PEA), whereas RV end-diastolic/left ventricular end-diastolic area ratio (RVEDA/LVEDA ratio) could be more useful. This study examined the relationship between RV annular parameters or RVEDA/LVEDA ratio and ideal cardiac index (ICI), before and after PEA. METHODS Among 80 patients who underwent PEA, the relationships between RVEDA/LVEDA ratio (21 patients), or tricuspid annular plane systolic excursion (32 patients), or systolic tricuspid annular velocity (55 patients) and ICI were modelled. RESULTS Forty-eight hours following PEA, mean pulmonary artery pressure decreased (26 ± 6 vs 46 ± 12 mmHg, P CONCLUSIONS Improved ICI and RVEDA/LVEDA ratio reflected the surgical success of PEA and lowering of total pulmonary resistances. In contrast to the RV/left ventricular area ratio, annular RV indices associated poorly with postoperative ICI. Recognizing this limitation is important in minimizing the overdiagnosis of RV dysfunction after PEA.
- Published
- 2020
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