Table 2 Summary of studies describing post-operative changes in right ventricular function and their clinical significance in patients undergoing noncardiac surgery
From: Epidemiology of perioperative RV dysfunction: risk factors, incidence, and clinical implications
Study | Surgical population | N | Age Proportion male (%) | Method of assessment | Definition of RVD | Postoperative change | Clinical significance/comments |
|---|---|---|---|---|---|---|---|
Reed et al. (1992) | Thoracic (lobectomy and pneumonectomy) | 15 | 65 (1.8) 80% | PAC | RVEF RVEDV | Early post-op vs POD2: • RVEF: 0.40 (0.01) to 0.36 (0.03) • RVEDV: 153 (10) to 173 (14) | ‘Three patients had periods of sustained atrial arrhythmias on POD 1 or 2 and at the time had significant increases in RVEDV’ |
Okada et al. (1994) | Thoracic (predominantly lobectomy) | 20 | 62 (49-77) 90% | PAC | RVEF RVEDV | Preop vs POD1 vs 3 weeks: • RVEF: 0.43 (0.07) to 0.36 (0.04) to 0.36 (0.34) (p < 0.05) • RVEDV increased on POD2: 112 (20) vs 130 (24) ml/m2 (p < 0.05) | RVEF remained depressed 3 weeks post-op |
Urban et al. (1996) | Orthopaedic (revision THJR) | 18 | 41–88 Not provided | PAC TOE (in some) | Decrease in RVEF ≥ 10% and increase PAP ≥ 10 mmHg | RVD in 4 of 18 (22%) at end of surgery | Transient increase in inotropic support. Mortality in one patient ‘complications related to bone cement implantation syndrome’ |
Xu et al. (2014) | Oesophagectomy | 40 | 59.0 (7.8) A 60.6 (6.6) A 73% | PAC | RVEF | Approx. 5% reduction overall at end of surgery | Not examined |
Wang et al. (2016) | Thoracic (pneumonectomy and lobectomy) | 30 | 53.1 ± 10.7 A 57.0 ± 11.4A 73% | TTE | RVFWLS RVGLS | All pre-op vs 1-week post-op: Pneumonectomy • RVFWLS: − 30.86 (5.88) to − 11.77 (4.14) • RVGLS: − 24.56 (5.32) to − 12.04 (5.33) Lobectomy • RVFWLS: − 29.7 (6.23) to − 18.03 (8.06) • RVGLS: − 25.69 (4.71) to − 17.07 (5.26) p < 0.05 for all | Not examined |
McCall et al. (2019) | Thoracic (anatomical lobectomy) | 27 | 67 (59-74) 37% | CMR | RVEF | RVEF deteriorated from 50.5% (6.9) pre-op to 44.9 (7.2) on POD2 (p = 0.003) | RVEF on POD2 associated with length of postoperative critical care unit stay (r =  − 0.653, p = 0.001) RVEF remains depressed vs. baseline 3-month post-op |
Segerstad et al. (2019) | Orthopaedic (THJR) | 22 | 76 (8.1) A 74 (6.2) A 36% | PAC | RVEF | 8% reduction in cemented, unchanged in uncemented | Not examined |
Gouvêa et al. (2022) | Liver transplantation | 19 | 52 (13) | TOE | TAPSE < 17 mm or FAC < 35% | No change at end of surgery | Right ventricular function was found to be normal throughout the procedure |