Echocardiography
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The vulnerability of right ventricle (RV) to ischemic insult during cardiac surgery is being increasingly recognized. This study aims to evaluate right ventricular function by measuring hepatic venous flow (HVF) patterns using intraoperative transesophageal echocardiography (TEE), and to compare HVF with other conventional two-dimensional echocardiographic and hemodynamic indices of RV performance. Patients undergoing coronary artery bypass grafting (CABG) were studied intraoperatively using a multiplane dual frequency 5/3.7-MHz phased array transducer, a pulmonary artery catheter, and an arterial catheter. ⋯ Hepatic systolic forward flow and TAPSE ratio can be an indirect measure of RV systolic functions in correlation with maximum major axis LA changes. Evaluation of HVF provides unique insight into right ventricular dynamics. It is an easy, safe, and sensitive method for assessing RV functions intraoperatively.