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Revista Uruguaya de Cardiología

versão impressa ISSN 0797-0048versão On-line ISSN 1688-0420

Resumo

VILASECA, Cecilia et al. Right ventricular failure in the postoperative period of heart valve surgery: prevalence, clinical and echocardiographic characteristics, and prognosis. Rev.Urug.Cardiol. [online]. 2024, vol.39, n.1, e201.  Epub 01-Dez-2024. ISSN 0797-0048.  https://doi.org/10.29277/cardio.39.1.5.

Introduction.

acute right ventricle (RV) failure in the postoperative period of cardiac surgery (POCC) constitutes a clinical challenge due to its significant morbidity and mortality. Recognition of the RV function importance in POCC is a recent fact, which can be evidenced by the absence of right ventricular function parameters in surgical risk stratification scores. Its definition varies according to different authors, it is difficult to know its prevalence and the factors associated with its development.

Objective:

to analyze the prevalence, clinical and echocardiographic characteristics, and prognosis of patients with RV failure in valvular POCC operated at the National Institute of Cardiac Surgery (INCC) in 2021 and to establish a comparison with patients operated on in the same period who did not develop this complication.

Method:

retrospective analytical observational study. Patients undergoing heart valve surgery in the INCC during 2021 were included. Acute RV failure in the POCC was considered as echocardiographic evidence of qualitatively defined right ventricular dysfunction in the postoperative echocardiogram. Statistical analysis was performed using SPSS version 26.0 software.

Results:

forty-five patients were included in the study, of which 7 (15.6%) developed RV failure in the POCC. There were no differences between baseline characteristics. The group that developed RV failure in POCC had a significantly lower left ventricular ejection fraction (LVEF) on preoperative echocardiography (p = 0.010). No differences were observed in the intraoperative variables. Regarding the prognosis, one patient from each group died in the immediate POCC.

Conclusions:

preoperative LVEF could play a role in predicting acute RV failure in valvular POCC, a finding to be verified in prospective studies. The impact of RV failure on mortality could not be defined given the limited number of patients.

Palavras-chave : ACUTE RIGHT VENTRICLE FAILURE; POSTOPERATIVE CARDIAC VALVULAR SURGERY.

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