Abstract 12109: Intra-Operative Evaluation of Right Ventricular Systolic Function After Elective Cardiac Surgery: A 2D and Speckle-Tracking Echocardiographic Study

IntroductionDecline in conventional longitudinal right ventricular (RV) indices in the post-operative period has been reported, though not well characterized and with unclear impact on RV functional sequalae. This phenomenon has yet to be studied in the acute cardiopulmonary bypass (CPB) period.HypothesisRV function, quantified using conventional and emerging methods including speckle-tracking echo, will provide new insights regarding the impact of CPB on RV regional and global function.MethodsComprehensive echocardiographic data were prospectively collected during elective cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE), peak systolic velocity (S’), and RV fractional area change (FAC) were quantified on transesophageal echo (TEE). RV global and regional (septal and free wall) longitudinal strain was obtained using speckle-tracking echo in RV focused views. Biplane method of disks was used to calculate 2D LV ejection fraction. Two time points intraoperatively were used for comparison, pre-sternotomy (pre-CPB) and after chest closure (post-CPB).ResultsPopulation comprised 49 patients undergoing cardiac surgery (29% valve surgery, 16% CABG, 10% CABG/valve surgery, 45% aortic surgery), among whom 47% had impaired RV function at baseline via conventional RV indices (TAPSE < 1.6 cm and S’ < 10 cm/s). Whereas RV indices including TAPSE, S’ and FAC all declined immediately following CPB (1.1±0.3 vs. 1.5±0.4 cm, 6.2±2.4 vs. 8.0±2.2 cm/s, 29.3±10.6 vs. 36.8±9.3%; p