Joshi Subodh B, Roswell Robert O, Salah Ali K, Zeman Peter R, Corso Paul J, Lindsay Joseph, Fuisz Anthon R
Section of Cardiology, Department of Medicine, Washington Hospital Center, Washington, DC, USA.
Cardiovasc Revasc Med. 2010 Apr-Jun;11(2):98-100. doi: 10.1016/j.carrev.2009.04.002.
A reduction in right ventricular function commonly occurs in the early postoperative period after coronary artery bypass graft surgery (CABG). We sought to determine the longer-term effect of CABG on right ventricular function.
Cardiac magnetic resonance imaging was performed before and approximately 3 months after surgery in 28 patients undergoing elective CABG. Right ventricular (RV) ejection fraction was assessed by planimetry of electrocardiographically gated cine images.
There was a statistically significant increase in left ventricular ejection fraction from 50% to 58% (P=.003) after CABG. RV ejection fraction also increased from 54% to 60% (P=.002). In patients with lower baseline RV ejection fraction (below the median, < 53%), this parameter improved from 47% to 57% (P<.001). Both on-pump (47% vs. 62%, P=.003) as well as off-pump CABG (47% vs. 55%, P=.009) lead to an improvement in RV function in patients in the initial low RV ejection fraction group.
Long-term right ventricular function was not adversely affected by CABG. An improvement in RV function occurred after surgery in patients with low baseline RV ejection fraction and was similar in patients who underwent surgery with or without cardiopulmonary bypass.
冠状动脉搭桥手术（CABG）术后早期常出现右心室功能下降。我们试图确定CABG对右心室功能的长期影响。
对28例行择期CABG的患者在手术前及术后约3个月进行心脏磁共振成像检查。通过对心电图门控电影图像进行面积测量来评估右心室（RV）射血分数。
CABG术后左心室射血分数从50%显著增加至58%（P = 0.003）。RV射血分数也从54%增加至60%（P = 0.002）。在基线RV射血分数较低（低于中位数，<53%）的患者中，该参数从47%提高至57%（P<0.001）。在初始RV射血分数较低的患者组中，体外循环（47%对62%，P = 0.003）以及非体外循环CABG（47%对55%，P = 0.009）均导致RV功能改善。
CABG对右心室长期功能无不利影响。基线RV射血分数较低的患者术后RV功能有所改善，且接受体外循环或非体外循环手术的患者情况相似。
