Perioperative Right Ventricular Pressure Monitoring in Cardiac Surgery

Meggie Raymond, Lars Grønlykke, Etienne J Couture, Georges Desjardins, Jennifer Cogan, Jennifer Cloutier, Yoan Lamarche, Philippe L L'Allier, Hanne Berg Ravn, Pierre Couture, Alain Deschamps, Marie-Eve Chamberland, Christian Ayoub, Jean-Sébastien Lebon, Marco Julien, Jean Taillefer, Antoine Rochon, André Y Denault

35 Citations (Scopus)

Abstract

Right ventricular (RV) dysfunction is a cause of increased morbidity and mortality in both cardiac surgery and noncardiac surgery and in the intensive care unit. Early diagnosis of this condition still poses a challenge. The diagnosis of RV dysfunction traditionally is based on a combination of echocardiography, hemodynamic measurements, and clinical symptoms. This review describes the method of using RV pressure waveform analysis to diagnose and grade the severity of RV dysfunction. The authors describe the technique, optimal use, and pitfalls of this method, which has been used at the Montreal Heart Institute since 2002, and review the current literature on this method. The RV pressure waveform is obtained using a pulmonary artery catheter with the capability of measuring RV pressure by connecting a pressure transducer to the pacemaker port. The authors describe how RV pressure waveform analysis can facilitate the diagnosis of systolic and diastolic RV dysfunction, the evaluation of RV-arterial coupling, and help diagnose RV outflow tract obstruction. RV pressure waveform analysis also can be used to guide pharmacologic treatment and fluid resuscitation strategies for RV dysfunction.

Original languageEnglish
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume33
Issue number4
Pages (from-to)1090-1104
Number of pages15
ISSN1053-0770
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • Cardiac Surgical Procedures/adverse effects
  • Humans
  • Monitoring, Intraoperative/methods
  • Perioperative Care/methods
  • Ventricular Dysfunction, Right/diagnostic imaging
  • Ventricular Function, Right/physiology
  • Ventricular Pressure/physiology

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