Right Ventricular Depression After Cardiopulmonary Bypass for Valvular Surgery

Objective To assess if right ventricular (RV) dysfunction is associated with increased mortality after cardiac surgery. Design Post-hoc analysis of a single-center double-blind randomized controlled trial. Setting University hospital. Participants A total of 120 patients undergoing simple or complex valvular surgery. Interventions Patients were randomized to receive intravenous amiodarone or placebo intraoperatively. As secondary analysis, patients were divided into those requiring or not requiring postoperative inotropic agents. Measurements and Main Results After cardiopulmonary bypass (CPB), there were significant increases in heart rate, cardiac index, systolic and mean arterial pressures, central venous pressure and pulmonary capillary wedge pressure with reduction in systemic vascular resistance (p Conclusions The increases in right-sided dimensions after CPB are associated with reduction in RV function and increased biventricular filling pressure, suggesting worsening biventricular function and interventricular dependence. Inotropic medications were associated with unaltered RV dimensions and increased biatrial activity.