• Neeki Alavi, Wilton Van Klei, Kwame Agyei, Amir Zabida, Mosana Abraha, Marcus Salvatori, Azad Mashari, and Justyna Bartoszko.
• Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
• Can J Anaesth. 2025 Feb 12.

PurposeAssessment of right ventricular (RV) function is recommended as part of a comprehensive echocardiography exam, including before and after cardiac surgery. Nevertheless, the prognostic implications of various measures of RV function in patients undergoing cardiac surgery are not well characterized. Our goal was to conduct a focused systematic review to assess the association of quantitative parameters of RV function with postoperative outcomes in patients undergoing cardiac surgery.MethodsWe conducted a systematic review of randomized controlled trials or observational studies in adult (≥ 18 yr) patients undergoing cardiac surgery with a reported echocardiogram within six months of surgery, intraoperatively, or shortly after surgery. We excluded case reports and case series. Databases included PubMed® and MEDLINE, and papers published from 1 January 1990 to 22 April 2024 were searched for. The primary predictors of interest were quantitative RV function parameters. The primary outcome of interest was postoperative mortality up to five years. The secondary outcome was all major adverse cardiac events (MACE).ResultsWe identified 7,187 potentially relevant studies, 27 of which were included; all of these were observational studies. Right ventricular fractional area change (RVFAC) was the most commonly reported parameter, but was inconsistently associated with mortality and MACE. Tricuspid annular plane systolic excursion (TAPSE) and strain were consistently associated with mortality. The most consistent predictor of MACE was RV myocardial performance index (MPI) across studies.ConclusionPre- and perioperative assessment of RV function using at least two quantitative echocardiographic parameters may offer prognostic information in patients undergoing cardiac surgery. Right ventricular FAC, TAPSE, strain, and RV MPI have been frequently studied; however, further research is needed to delineate the role of echocardiographic RV quantification for perioperative prognostication.Study RegistrationPROSPERO ( CRD42023387383 ); first submitted 23 December 2022.© 2025. Canadian Anesthesiologists' Society.

4 keywords...

hide…