Title |
The impact of pericardial approach and myocardial protection onto postoperative right ventricle function reduction
|
---|---|
Published in |
Journal of Cardiothoracic Surgery, June 2018
|
DOI | 10.1186/s13019-018-0726-5 |
Pubmed ID | |
Authors |
Marco Zanobini, Claudia Loardi, Paolo Poggio, Gloria Tamborini, Fabrizio Veglia, Alessandro Di Minno, Veronika Myasoedova, Liborio Francesco Mammana, Raoul Biondi, Mauro Pepi, Francesco Alamanni, Matteo Saccocci |
Abstract |
The reduction of RV function after cardiac surgery is a well-known phenomenon. It could persist up-to one year after the operation and often leads to an incomplete recovery at follow-up echocardiographic control. The aim of the present study is to analyze the impact of different modalities of pericardial incision (lateral versus anterior) and of myocardial protection protocols (Buckberg versus Custodiol) onto postoperative RV dynamic by relating two- and three-dimensional echocardiographic parameters in patients undergoing mitral valve repair through minimally invasive or traditional surgery approach. We have analyzed 44 consecutive patients with severe degenerative mitral regurgitation who underwent mitral reparation with different surgical approach and cardioplegia type: Group 1 (17 pts): sternotomy with Buckberg cardioplegia protocol; Group 2 (10 pts): sternotomy with Custodiol cardioplegia; Group 3 (17 pts): mini-invasive surgery with Custodiol cardioplegia. Two-dimensional transthoracic echocardiography was performed pre- and 6 months post-surgery to evaluate RV function by tricuspid annular plane systolic excursion (TAPSE). All patients underwent successful and uneventful. A postoperative TAPSE reduction was found in all groups. However, mini-invasive patients experienced a significant reduced variation versus traditional surgery. Mini-invasive mitral repair, with lateral incision of pericardium, reduces postoperative TAPSE fall, while cardioplegia protocol fails to have an impact onto longitudinal RV function. In our study, the RV seems to experience a clinically irrelevant geometrical modification too, whose entity appears to be less evident in case of lateral pericardial approach. These results could strengthen the use of minimally invasive approach also to preserve RV function. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 33% |
Unknown | 2 | 67% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 3 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 29 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 6 | 21% |
Researcher | 5 | 17% |
Other | 4 | 14% |
Student > Ph. D. Student | 3 | 10% |
Student > Postgraduate | 2 | 7% |
Other | 4 | 14% |
Unknown | 5 | 17% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 14 | 48% |
Materials Science | 2 | 7% |
Unspecified | 1 | 3% |
Physics and Astronomy | 1 | 3% |
Unknown | 11 | 38% |