Echocardiographic Evaluation of Right Ventricular Function in the Immediate Postoperative Period after Major Pulmonary Resections: A Prospective Observational Study

Abstract

ABSTRACT Aim We aimed to identify the impact through the use of standard and novel echocardiographic parameters, i.e., speckle tracking echocardiography (STE) to evaluate the right and left ventricular (LV) myocardial function in patients who underwent lung resections. Materials and methods We identified patients that underwent lobectomy or pneumonectomy at our institution in 2016 to 2017. We performed preoperative transthoracic echocardiography (TTE) in each patient and on postoperative days (PODs) 2, 7, and 30 when available. Results Of a total of 26 patients included in the study, 5 underwent pneumonectomy, while the rest underwent lobectomy. Left and right pneumonectomy was performed in 38 and 62% of the patients respectively. None of the patients had right ventricular (RV) dilation or dysfunction on preoperative echocardiograms. Postoperatively, mean LV ejection fraction (LVEF) was 52 (±7.5) %. Mean RV strain in immediate postoperative period (day 2) was –15.1% (reduction of more than 20%). None of the patients progressed to RV failure or had mortality. Estimated RV systolic pressure was 41 (±20) mm Hg. The differences in RV echocardiographic parameters were significantly different pre- and postsurgery. The RV function decreased significantly on POD 2, which improved slightly thereafter. Extent of resection and side of resection did not make a difference in the RV functions. Conclusion After lung resection, patients developed deterioration in RV function that may be reflected by any of the echocardiographic parameters used to assess RV function. Deterioration in RV function is maximum in the immediate postoperative period (day 2), which improves to preoperative level by 4 weeks. How to cite this article Bhat IH, Kumar A, Kumar B, Ganesan R, Mandal B, Dutta V. Echocardiographic Evaluation of Right Ventricular Function in the Immediate Postoperative Period after Major Pulmonary Resections: A Prospective Observational Study. J Perioper Echocardiogr 2017;5(2):42-48.