Right ventricular function after coronary artery bypass grafting in patients with and without revascularization of the right coronary artery.
OBJECTIVE
To evaluate the influence of revascularization of a stenosis of the right coronary artery on right ventricular function.


METHODS
Prospective study.


METHODS
Single institutional study in a university hospital.


METHODS
20 patients with different degrees of stenosis of the right coronary artery undergoing elective coronary artery bypass grafting.


METHODS
In 10 patients, bypass surgery included revascularization of a significant stenosis of the right coronary artery (group 1). In 10 other patients, the pathology of the right coronary artery was judged to be not significant, without indication for revascularization (group 2).


RESULTS
Using the fast-response thermodilution pulmonary artery catheter, right ventricular function was estimated perioperatively. After termination of extracorporeal circulation, there was an increase in right ventricular volumes in group 2 (p < 0.05) and an initial decrease in group 1 (p < 0.05), with higher volumes in group 2 compared with group 1 (p < 0.05). The ejection fraction increased in group 1 (p < 0.05) and decreased in group 2 after operation (p < 0.05), with higher values in group 1 compared with group 2 (p < 0.05). In addition to these findings, the pressure-volume relationship showed a leftward and upward shift in group 1 and a rightward shift in group 2 postoperatively.


CONCLUSIONS
These results indicate that right ventricular depression can occur after bypass grafting in patients with a moderate stenosis of the right coronary artery that is not revascularized. Revascularization of more severe stenosis of the right coronary artery appears to preserve postoperative right ventricular function.
Schirmer
U
U
Department of Anesthesiology, University of Ulm, Germany.
Calzia
E
E
Lindner
K H
KH
Hemmer
W
W
Georgieff
M
M
D002306:Cardiac Volume; D002407:Catheterization, Swan-Ganz; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000473:pathology / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures; D005112:Extracorporeal Circulation; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications; D011446:Prospective Studies; D013318:Stroke Volume; D013815:Thermodilution; D018497:Ventricular Dysfunction, Right / Q000209:etiology; D016278:Ventricular Function, Right; D017725:Ventricular Pressure