Changes in Right Ventricular Function After Off-Pump Coronary Artery Bypass Grafting

Borde, Deepak; Joshi, Pooja; Joshi, Shreedhar; Asegaonkar, Balaji; Apsingekar, Pramod; Khade, Sujeet; Pande, Swati; Agrawal, Ajai; Puranik, Manish

doi:10.1053/j.jvca.2020.06.086

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…Lue et al demonstrated that the index of LVDD indexes before and after CABG did not differ significantly, which is compatible with the results of this study (18). On the other hand, in a study by Bord et al that looked at changes in RV function after off-pump CABG, patients' RVDD grade was normal before surgery but significantly different after surgery (19). The reason for the discrepancy between the results can be because, in the present study, most patients underwent on-pump surgery; on the other hand, the second evaluation of patients was done one month after surgery, while in this study, the second evaluation was performed when patients were transferred to the ward.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of right ventricular diastolic dysfunction after Coronary Artery Bypass Grafting (CABG) surgery

Faghani

Khansari

Homayounfar

et al. 2022

Preprint

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Background: Coronary artery bypass grafting (CABG) is a surgical procedure used in the treatment of coronary artery disease and to improve heart function. Right ventricular (RV) function is unclear based on myocardial velocities before and after coronary artery bypass graft surgery. RV dysfunction is a known cause of hypotension in early CABG surgery. The diastolic function has been shown to be a significant contributor to mortality and cardiac morbidity in recent years. Our study aimed to assess RV diastolic dysfunction after CABG surgery. Methods: Forty-four patients with the two-vessel disease (2 VD), small vessel disease (SVD) and three-vessel disease (3 VD) facial ischemia candidates for CABG surgery were studied. All patients underwent colour Doppler and RV strain echocardiography before and one month after CABG surgery, and patients’ RV function indices were calculated. Data analysis was performed using SPSS 21 software and a value of P<0.05 was considered statistically significant. Results: Out of forty patients, the male to female ratio was 32:8 and their mean age was 65.17 ± 7.87 years and their mean body mass index was 25.59± 3.20. Four patients were operated on without pumps. One month after CABG, systolic pulmonary artery pressure (SPAP), left ventricular ejection fraction (LVEF) and RV Diameter indexes increased significantly. Fractional area change (FAC), RV global longitudinal strain (GLS), Tissue Doppler imaging systolic wave (SM), RV myocardial perfusion imaging (MPI) and Tricuspid annular plane systolic excursion (TAPSE) decreased, which was less in the 3VD group than in the 1VD/2VD group (P <0.001). There was no significant difference between RV diastolic diameter (RVDD) and left ventricular diastolic diameter (LVDD) before and one month after CABG (P <0.05). Additionally, no significant correlation was detected between changes in RV strain and pump connection time. Conclusion: RV diastolic function is significantly reduced after CABG surgery. Surgery without the pump can certainly not eliminate this dysfunction and be effective in reducing its severity.

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Section: Discussionsupporting

confidence: 90%

Evaluation of right ventricular diastolic dysfunction after Coronary Artery Bypass Grafting (CABG) surgery

Faghani

Khansari

Homayounfar

et al. 2022

Preprint

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“…A recent study showed that a decrease in the mechanical function of the right ventricle (as assessed using a three-dimensional-derived RV free-wall strain) does not occur during surgery (before and after sternotomy) but after isolated CABG with cardiopulmonary bypass [ 22 ]. However, a significant decrease in right ventricular longitudinal function (TAPSE and s’) was also noted after off-pump CABG [ 23 ]. The use of mitral valve repair through a minimally invasive surgery approach (with lateral pericardial incision) was accompanied by a smaller decrease in TAPSE in the postoperative period than in traditional surgery with anterior pericardial incision [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Indicators of the Right Ventricle Systolic and Diastolic Function 18 Months after Coronary Bypass Surgery

Sumin

Щеглова

Корок

et al. 2022

JCM

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Objective. Right ventricular (RV) dysfunction after coronary artery bypass grafting (CABG) is associated with increased mortality and morbidity. In previous studies, the parameters of RV systolic function were mainly assessed, while the dynamics of RV diastolic function after surgery was practically not studied. The aim of this study was to study the dynamics of indicators of systolic and diastolic RV function after CABG as well as to identify factors associated with their presence. Methods. The study included 160 patients who underwent CABG and 36 volunteers with no history of coronary artery disease (CAD) as a control group. Echocardiographic examination of patients was performed to assess systolic and diastolic RV dysfunction before surgery and 18 months after CABG. A level of s’t < 10 cm/sec or TAPSE < 16 mm was considered as a sign of existing RV systolic dysfunction. RV diastolic dysfunction was defined as an Et/At ratio < 0.8 or >2.1 and/or an Et/et’ ratio > 6. Results. In CAD patients 18 months after CABG, there was an increase in the frequency of the right ventricular systolic (from 7.5% to 30%, p < 0.001) and diastolic (from 41.8% to 57.5%, p < 0.001) dysfunction. An increase in TAPSE (p = 0.007), a decrease in e’t (p = 0.005), and the presence of RV systolic dysfunction before surgery (p = 0.023) was associated with a significant increase in the likelihood of detecting RV systolic dysfunction 18 months after CABG (χ2(3) = 17.4, p = 0.001). High values of At before surgery (p = 0.021) and old myocardial infarction (p = 0.023) were significantly associated with an increased likelihood of detection of RV diastolic dysfunction 18 months after CABG (χ2(2) = 10.78, p = 0.005). Conclusions. This study demonstrated that in CAD patients 18 months after CABG, there was an increase in the frequency of right ventricular systolic and diastolic dysfunction. We also established the initial clinical, echocardiographic parameters, and perioperative complications associated with the presence of these changes in the postoperative period. The clinical and prognostic significance of the presence of systolic and/or diastolic RV dysfunction in patients 18 months after CABG remains to be explored.

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“…Cardiopulmonary bypass coronary artery bypass graft requires the body to remain in a state of shock, and then the cardiopulmonary bypass is performed for related interventions, which has shown a certain clinical effect (9). However, Borde et al (10) found that cardiopulmonary bypass coronary artery bypass graft causes a certain degree of damage to the patient's body. When the body is in a state of shock, inflammation is easily induced, as are symptoms such as vasoconstriction and thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

Effects of off-pump coronary artery bypass graft on the clinical efficacy, surgical indicators, and cardiac function of patients with coronary heart disease

Ma¹,

Liao²,

Shi³

et al. 2021

Ann Palliat Med

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Background: Coronary heart disease (CHD) is a common clinical cardiovascular disease. This study aimed to analyze the effects of off-pump coronary artery bypass graft on the clinical efficacy, surgical indicators, and cardiac function of patients with CHD. Methods:We retrospectively analyzed the clinical data of 120 patients with CHD who were treated in our hospital from May 2017 to May 2020. And they were divided into the control group (extracorporeal coronary artery bypass graft) and the observation group (off-pump coronary artery bypass graft). The clinical efficacy, surgical indicators, cardiac function, myocardial injury, the degree of cardiac autonomic nerve imbalance, incidence of complications and quality of life one year after the operation in the 2 groups were compared.Results: The total effective rate of the observation group was significantly higher than that of the control group. Intraoperative blood loss, operation time, intraoperative blood transfusion, and hospital stay in the observation group were significantly better than those in the control group. After treatment, the levels of cardiac index (CI), ejection fraction (EF), stroke volume (SV), and cardiac output (CO) in the observation group and the control group were higher than those before treatment, especially in the observation group.Compared with those before operation, CK-MB and cTnI of the two groups significantly increased at all time points after surgery. After treatment, SDNN, LF, HF, and TP of patients in the two groups increased, which was significant in the observation group. The incidence of complications such as myocardial infarction, ischemic changes, respiratory insufficiency, and intraoperative ventricular fibrillation in the observation group was significantly lower than that in the control group. The score of quality of life in the observation group was significantly higher than the control group. Conclusions:In the treatment of patients with CHD, off-pump coronary artery bypass graft has good clinical effects, which can significantly improve the heart function, and cardiac autonomic nerve imbalance of patients, reduce myocardial damage, decrease the incidence of complications, and improve the quality of life.Therefore, off-pump coronary artery bypass graft is worthy of clinical application.

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Changes in Right Ventricular Function After Off-Pump Coronary Artery Bypass Grafting

Cited by 5 publications

References 36 publications

Evaluation of right ventricular diastolic dysfunction after Coronary Artery Bypass Grafting (CABG) surgery

Evaluation of right ventricular diastolic dysfunction after Coronary Artery Bypass Grafting (CABG) surgery

Indicators of the Right Ventricle Systolic and Diastolic Function 18 Months after Coronary Bypass Surgery

Effects of off-pump coronary artery bypass graft on the clinical efficacy, surgical indicators, and cardiac function of patients with coronary heart disease

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