Early recovery of tricuspid annular isovolumic acceleration after mitral valve surgery – an observational study
| Autor: | Claude Tousignant, Jordan R. Van Orman, Kim A. Connelly, Zakariya Albinmousa |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Heart Ventricles 030204 cardiovascular system & hematology Doppler echocardiography 03 medical and health sciences 0302 clinical medicine Interquartile range medicine.artery Anesthesiology Internal medicine Mitral valve medicine Humans Postoperative Period Cardiac Surgical Procedures Tricuspid valve medicine.diagnostic_test business.industry General Medicine Perioperative Middle Aged Echocardiography Doppler Cardiac surgery Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure 030228 respiratory system Echocardiography Anesthesia Pulmonary artery Ventricular Function Right Cardiology Mitral Valve Female Tricuspid Valve business |
| Zdroj: | Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 63:920-927 |
| ISSN: | 1496-8975 0832-610X |
| DOI: | 10.1007/s12630-016-0651-9 |
| Popis: | Patients undergoing mitral valve surgery are at risk for right ventricular (RV) dysfunction resulting from increased left atrial pressure and increased pulmonary artery impedance. Measures of longitudinal measures of RV function, such as displacement, are commonly performed but have been shown to be depressed after cardiac surgery despite good patient recovery. The aim of this observational study was to assess the early perioperative time course of longitudinal transthoracic echocardiographic (TTE) markers of RV function in a patient population undergoing mitral valve surgery. Twenty patients undergoing mitral valve surgery were enrolled in this observational study. Right ventricular longitudinal measurements (tricuspid annular plane systolic excursion [TAPSE], strain, annular velocity [S′], and isovolumic acceleration [IVA]) were performed using TTE and colour Doppler imaging preoperatively (day 1) and postoperatively (days 2 and 6). Comparisons were made between the preoperative and postoperative measurements. Adequate echocardiographic imaging was obtained for all 20 patients. The TAPSE, strain, and S′ measures remained depressed for up to one week (i.e., day 6) after surgery compared to preoperative values. The IVA was depressed on the first postoperative day (P > 0.001), but by day 6 it was no different from the preoperative value (P = 0.37). The median [interquartile range] time to discharge from hospital was 7 [6-9] days. Persistent, significant depression of longitudinal markers of RV function despite functional improvement (discharge from hospital) make it difficult to assess recovery during the early perioperative period. Isovolumic acceleration, a load-independent measure of contractility, might be a more reliable measure of early recovery in RV function in this patient population. |
| Databáze: | OpenAIRE |
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