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