• André Denault, Etienne J Couture, Tjorvi Perry, Elena Saade, Alexander Calderone, Yu Hao Zeng, Daniel Scherb, Kevin Moses, Cristhian Potes, Ali Hammoud, William Beaubien-Souligny, Mahsa Elmi-Sarabi, Lars Grønlykke, Yoan Lamarche, Jean-Sébastien Lebon, Nicolas Rousseau-Saine, Georges Desjardins, and Antoine Rochon.
• Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada. Electronic address: andre.denault@umontreal.ca.
• J. Cardiothorac. Vasc. Anesth. 2024 Aug 1; 38 (8): 167316821673-1682.

ObjectiveRight ventricular (RV) dysfunction in cardiac surgery can lead to RV failure, which is associated with increased morbidity and mortality. Abnormal RV function can be identified using RV pressure monitoring. The primary objective of the study is to determine the proportion of patients with abnormal RV early to end-diastole diastolic pressure gradient (RVDPG) and abnormal RV end-diastolic pressure (RVEDP) before initiation and after cardiopulmonary bypass (CPB) separation. The secondary objective is to evaluate if RVDPG before CPB initiation is associated with difficult and complex separation from CPB, RV dysfunction, and failure at the end of cardiac surgery.DesignProspective study.SettingTertiary care cardiac institute.ParticipantsCardiac surgical patients.InterventionCardiac surgery.Measurements And Main ResultsAutomated electronic quantification of RVDPG and RVEDP were obtained. Hemodynamic measurements were correlated with cardiac and extracardiac parameters from transesophageal echocardiography and postoperative complications. Abnormal RVDPG was present in 80% of the patients (n = 105) at baseline, with a mean RVEDP of 14.2 ± 3.9 mmHg. Patients experienced an RVDPG > 4 mmHg for a median duration of 50.2% of the intraoperative period before CPB initiation and 60.6% after CPB separation. A total of 46 (43.8%) patients had difficult/complex separation from CPB, 18 (38.3%) patients had RV dysfunction, and 8 (17%) had RV failure. Abnormal RVDPG before CPB was not associated with postoperative outcome.ConclusionElevated RVDPG and RVEDP are common in cardiac surgery. RVDPG and RVEDP before CPB initiation are not associated with RV dysfunction and failure but can be used to diagnose them.Copyright © 2024 Elsevier Inc. All rights reserved.

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