Right ventricular failure: observations of the interrelationships affecting RV failure after aortocoronary bypass, valve surgery, and congenital heart defect repair.
Right ventricular dysfunction in adult coronary artery bypass surgery with or without ventricular aneurysm repair has not been a source of hospital mortality in our institution, whereas it persists as a cause of death not infrequently after repair of congenital heart disease and, on occasion, after valvular surgery. Although we have strong clues as to the true nature of this dichotomy, there are so many factors involved with open congenital heart repairs that the explanation is not certain. Considering the coronary anatomy, the character of right ventricular infarction, the total lack of reports of post-operative angiography, and our clinical results, we have not found sufficient evidence at this time to recommend bypass to right ventricular coronary branches. We believe that the use of a checklist of right ventricular dysfunction after congenital heart repair may result in detection of a reversible cause of right ventricular dysfunction that could be fatal.
D001026:Coronary Artery Bypass; D006330:Heart Defects, Congenital / Q000601:surgery*; D006331:Heart Diseases / Q000601:surgery; D006333:Heart Failure / Q000209:etiology*; D006351:Heart Valves / Q000601:surgery*; D006352:Heart Ventricles; D006801:Humans; D007223:Infant; D011183:Postoperative Complications