Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
Department of Cardiology, University of Palermo, Palermo, Italy.
Heart Fail Rev. 2019 Sep;24(5):625-635. doi: 10.1007/s10741-019-09785-2.
Cardiac surgical techniques and circulatory supports have strongly evolved in the last years. Right ventricular (RV) function during the post-operatory period is still subject of study, although its relevant prognostic impact has been variably described in different papers. RV post-surgical dysfunction's underlying mechanisms are still not clear and include a different hypothesis. Echocardiography, with both first and second level parameters, offers the possibility to accurately analyze the right ventricle and optimize these patients' management. This paper describes the pathophysiology of the right ventricle, the most used echo indexes of RV function, whether they alter after surgery, the different supposed mechanisms of RV dysfunction and its role in the prognosis of patients undergoing cardiac surgery.
近年来,心脏外科技术和循环支持手段取得了长足的发展。尽管不同文献对右心室(RV)术后功能的预后影响有不同的描述,但 RV 在术后期间的功能仍然是研究的课题。RV 术后功能障碍的潜在机制尚不清楚,包括不同的假设。超声心动图,结合一级和二级参数,提供了准确分析右心室并优化这些患者管理的可能性。本文描述了右心室的病理生理学,最常用的 RV 功能超声心动图指标,这些指标在手术后是否发生改变,RV 功能障碍的不同假设机制及其在心脏手术后患者预后中的作用。