Di Virgilio Emanuele, Basile Paolo, Carella Maria Cristina, Monitillo Francesco, Santoro Daniela, Latorre Michele Davide, D'Alessandro Silvia, Fusini Laura, Fazzari Fabio, Pontone Gianluca, Guaricci Andrea Igoren
Cardiology Unit, Hospital of Corato, ASL Bari, 70033 Corato, Italy.
University Cardiology Unit, Interdisciplinary Department of Medicine, "Aldo Moro" University School of Medicine, AOUC Polyclinic, 70121 Bari, Italy.
J Clin Med. 2024 Apr 17;13(8):2309. doi: 10.3390/jcm13082309.
The interventricular septum (IVS) is a core myocardial structure involved in biventricular coupling and performance. Physiologically, during systole, it moves symmetrically toward the center of the left ventricle (LV) and opposite during diastole. Several pathological conditions produce a reversal or paradoxical septal motion, such as after uncomplicated cardiac surgery (CS). The postoperative paradoxical septum (POPS) was observed in a high rate of cases, representing a in the panorama of paradoxical septa as it does not induce significant ventricular morpho-functional alterations nor negative clinical impact. Although it was previously considered a postoperative event, evidence suggests that it might also appear during surgery and gradually resolve over time. The mechanism behind this phenomenon is still debated. In this article, we will provide a comprehensive review of the various theories generated over the past fifty years to explain its pathological basis. Finally, we will attempt to give a heuristic interpretation of the biventricular postoperative motion pattern based on the switch of the ventricular anchor points.
室间隔（IVS）是参与双心室耦合和功能的核心心肌结构。生理上，在收缩期，它对称地向左心室（LV）中心移动，而在舒张期则相反。几种病理状况会导致室间隔运动逆转或呈矛盾运动，比如在无并发症的心脏手术后（CS）。术后矛盾性室间隔（POPS）在高比例病例中被观察到，它在矛盾性室间隔的全景中具有独特性，因为它不会引起显著的心室形态功能改变，也不会产生负面临床影响。尽管它以前被认为是术后事件，但有证据表明它也可能在手术期间出现，并随时间逐渐消退。这种现象背后的机制仍存在争议。在本文中，我们将全面回顾过去五十年来为解释其病理基础而产生的各种理论。最后，我们将尝试基于心室锚点的切换对双心室术后运动模式给出一种启发性解释。
