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Eur J Cardiothorac Surg 1999;14:250-255
© 1999 Elsevier Science NL

Contribution of the interventricular septum to maximal right ventricular function

^a Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Medizinische Hochschule Hannover, Hannover, Germany
^b Department of Surgery, Cardiac Surgery Division, Massachusetts General Hospital, Boston, MA, USA
^c Harvard Medical School, Boston, MA, USA

Received 2 March 1998; received in revised form 2 June 1998; accepted 9 June 1998.

Corresponding author. Abteilung Thorax-Herz- und Gefäßchirurgie, Medizinische Hochschule Hannover, D-30623 Hannover, Germany. Tel.: +49 511 5323453; fax: +49 511 5325404; e-mail: klima@thg.mh-hannover.de

Objective: Maximal right ventricular (RV) function is influenced by left heart hemodynamics, possibly mediated by the interventricular septum (IVS). We examined the potential contribution of the IVS function to right heart function. Methods: In 12 canine isovolumic right heart preparations, incremental volumes were introduced into a high compliance RV balloon until RV failure occurred. Maximal RV developed pressure (RVDP) and maximal positive RV dP/dt were determined with a working IVS at a constant left ventricular (LV) output of 2 l/min and at a constant mean arterial pressure of 80 mmHg. Thereafter the IVS was thermally inactivated, and measurements were repeated using the same protocol. Results: At constant arterial pressure and constant LV output, thermal inactivation of the IVS led to a significant decrease in maximal RVDP (inactivated vs. working IVS: 36.1±9.8 vs. 56.8±16.2 mmHg, respectively, P<0.001), and RV dP/dt (inactivated vs. working IVS: 720±220 vs. 1350±190 mmHg/s, respectively, P<0.001). Conclusions: These results suggest that the functional status of the IVS is a major determinant of maximal RV function. At constant LV conditions and arterial pressure, an inactivated IVS leads to a significant decrease in maximal RVDP and RV dP/dt under the conditions of this study.

Key Words: Interventricular septum • Right ventricular failure • Cardiac transplantation • Circulatory assist

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