Clinical implication of intraoperative ventricular‐arterial coupling in pediatric patients undergoing ventricular septal defects repair: A retrospective cohort study

Background Ventricular‐arterial coupling is the ratio of arterial elastance to ventricular end‐systolic elastance. Aims The objective of this study was to determine the clinical implication of intraoperative ventricular‐arterial coupling derived from the pressure‐area relationship using transesophageal echocardiography. Methods This retrospective study reviewed the medical records of 72 pediatric patients with ventricular septal defects who underwent corrective surgery with cardiopulmonary bypass. The single‐beat modified method was used to assess ventricular‐arterial coupling. Logistic regression analyses were performed to determine the correlation between ventricular‐arterial coupling and early postoperative outcomes, including the maximum vasoactive‐inotropic score, length of mechanical ventilation, and length of hospital stay. Results Ventricular‐arterial coupling after cardiopulmonary bypass significantly increased (from 1.0 ± 0.4 to 1.4 ± 0.8, p 7 days; OR: 2.98; 95% CI: 1.04–8.58, p = .043). Conclusions Ventricular‐arterial coupling can be easily obtained from the intraoperative transesophageal echocardiography in pediatric patients undergoing ventricular septal defects repair. High postoperative ventricular‐arterial coupling is strongly associated with worse early postoperative outcomes. Ventricular‐arterial coupling shows promise as an intraoperative analysis tool that can provide insight into the impact of interventions on cardiovascular performance and identify potential targets for treatment in this population.