Prognostic value of right ventricular dysfunction on clinical outcomes for patients undergoing surgical interventions for mitral valve

Abstract

Background: Between 40 and 60% of individuals following cardiac surgery report having postoperative right ventricular dysfunction (RVD), which is a manifestation of decreased septal function (paradoxical septal motion). Aim and objectives: To investigate the association between RVD and the outcome of cardiac surgery for mitral valve intervention including morbidity and mortality up to 3 months after surgery. Patients and Methods: A total of 47 patients were included in the prospective observational comparative evaluation, which was split into two groups, group 1 [high risk group tricuspid annular plane systolic excursion (TAPSE) less than 1.6] and group 2 (low risk group TAPSE more than 1.6). The study took place from August 2019 to August 2021 at the National Heart Institute (NHI) and the Cardiothoracic Surgery Department of Ain Shams University. Results: There were nonsignificant differences demonstrated between the groups in terms of age, gender, body mass index (BMI), mitral pathology, the duration of mechanical ventilation, ICU length of stay, the incidence of postoperative bleeding, the volume of postoperative bleeding, the composite endpoint of complications, the type of complication, or the lengths of ICU stay. The high-risk group’s TAPSE scores were found to be considerably lower at the 3-month evaluation ( P<0.001 ). Only two variables, preoperative TAPSE and cross-clamp time, were found to be statistically significant in predicting the risk of all-cause death, according to the findings of the multivariate regression analysis. Conclusion: RV dysfunction was detected by a thorough preoperative echocardiographic evaluation. Reducing surgical adverse events and mortality may be possible with the identification of preoperative RV dysfunction.