Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Right ventricular remodeling in patients after aortocoronary bypass surgery

Authors: Dmitriev O.V.1, Terеshina O.V.2, Gryaznova D.A.1, Luchkina E.A, 1 Poltaeva M.N.1, Generalova A.V.1, Vachev A.N.1

Company:
1 Samara State Medical University, Ministry of Health of Russia, Samara, Russian Federation
2 Royal Brompton Hospital, London, UK

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DOI: https://doi.org/10.24022/1814-6910-2024-21-2-107-116

UDC: 616.124.3-089.86

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (2): 107-116

Quote as: Dmitriev O.V., Tereshina O.V., Gryaznova D.A., Luchkina E.A., Poltaeva M.N., Generalova A.V., Vachev A.N. Remodeling of the right ventricle in patients after ACS surgery. Clinical Physiology of Circulation. 2024; 21 (2): 107–116 (in Russ.). DOI: 10.24022/1814-6910-2024-21-2-107-116

Received / Accepted:  27.05.2024 / 21.06.2024

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Abstract

Objective: to determine the significance of echocardiographic criteria to assess reverse remodeling of the right ventricular (RV) after coronary artery bypass grafting (CABG) surgery in patients with baseline right ventricular myocardial infarction (RVMI).

Material and methods. The study retrospectively analyzed 104 treated patients with tricuspid coronary lesions in 2022. Depending on the initial right RVMI anamnesis, the patients were divided into 2 groups: the first group (n = 97) – patients without RVMI, the second group (n = 7) – patients with RVMI anamnesis. All patients underwent CABG surgery. Basal diameter (mm), mean diameter (mm), diameter of the proximal part of the outflow tract (mm), diameter of the distal part of the outflow tract (mm), TAPSE (mm) were evaluated by echo before and after the operation.

Results. All patients in group I after CABG surgery had clinical improvement in the form of disappearance of clinical signs of angina pectoris and improvement of RV function according to cardiac echo data. In group II 2 patients died due to the development of RVMI. All survivors patients after CABG operation had disappearance of clinical manifestations of angina pectoris, 2 patients still had dyspnea. Group II patients showed more pronounced remodeling and improvement of RV function according to echo data.

Conclusion. CABG surgery leads to clinical improvement and significantly affects the structure of the right ventricle in patients with initial ventricular dysfunction. Echo parameters such as mean right ventricular diameter, proximal outflow tract diameter, and TAPSE change most significantly.

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