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Eur J Cardiothorac Surg 1999;15:444-448
© 1999 Elsevier Science NL

Right ventricular morphology and function after pulmonary resection¹

Janusz Kowalewski, Marian Brocki, Tadeusz Dryjaski, Krzysztof Kapro, Stanisaw Barcikowski

Military Medical Academy, Lodz, Poland

Received 21 September 1998; received in revised form 14 December 1998; accepted 12 January 1999.

Corresponding author. SK WAM, ul. Zeromskiego 113, 90–549 Lodz, Poland. Tel.: +48-42-6333-890; fax: +48-42-6333-890; e-mail: wam1klch@polbox.com

Objective: To identify the effect of pulmonary resection on right ventricular performance and its possible contribution to mortality and morbidity. Methods: Before and 2 days after pulmonary resection for primary lung cancer in 31 patients (21 males; ages 32–69 years), echocardiographic examinations of the right ventricle were performed. Systolic, diastolic and stroke volumes as well as right ventricular ejection fraction were estimated. Right ventricular volumes were calculated using the subtracting method. Results: Right ventricular end-diastolic volume index increased significantly in patients after pneumonectomy: 80.4±7.2 ml/m² versus preoperative evaluation: 66.1±5.2 ml/m² (P=0.031). In patients who underwent pneumonectomy right ventricular ejection fraction significantly decreased from 48±5.0% preoperatively to 39%±4.1% after surgery (P=0.027). Fourteen patients after pneumonectomy had development of supraventricular arrhythmias postoperatively. These patients had much higher right ventricular end-diastolic volume index (76.3±6.4/82.1±7.4; P=0.032) and lower right ventricular ejection fraction (42±4.3/37±3.9; P=0.021) after surgery in comparison with patients who had normal sinus rhythm postoperatively. Conclusion: Pulmonary resection caused a significant dilatation and dysfunction of right ventricle in the early postoperative period. Early detection of deterioration in right ventricular function after pneumonectomy may provide the opportunity for interventional therapy.

Key Words: Lung cancer • Surgery • Pneumonectomy • Right ventricle • Echocardiography

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