A study of right ventricular function in pre-and post-valvular surgeries

Abstract

Aims: The aim of this study is to compare tricuspid annular plane systolic excursion (TAPSE) in pre-and postoperative valvular heartsurgery patients using M-mode imaging, to determine changes in tissue Doppler parameters among patients undergoing valvular heart surgery, and toanalyze tissue deformation parameters of right ventricle (RV) and RV strain in pre-and postoperative patients. Materials and methods: This was anobservational, cross-sectional, single-center study that included 24 patients who underwent echocardiographic assessment prior to surgery, aftersurgery, and at 1-month follow-up. Assessment of left and right ventricles by M-mode echocardiography, evaluation of RV by 2D Dopplerechocardiography, tissue Doppler imaging, and strain imaging were performed. Results: The TAPSE was significantly reduced immediately aftersurgery (14.8 ± 0.37 vs. 10.9 ± 0.26 mm), which was then improved on follow-up assessment (17.8 ± 34 mm) (p = 0.001). Tricuspid valve diastolicvelocity was increased after surgery and then gradually declined at 1-month follow-up (p = 0.003). Presurgery RV free wall strain was found to bereduced, which was then improved during post-procedure analysis as well as on follow-up (p = 0.001). Conclusions: After cardiac valvular surgery, RVmyocardial deformation showed a gradual improvement after 1 month, although there was an immediate decline in RV function postsurgery. Thepattern of RV contraction, as showed by RV strain, varied postsurgery, which was remarkably increased in postoperative patients at the time of followup. Tissue deformation imaging being an emerging technique helps in the assessment of minute, subtle changes that occur in the RV myocardialfunction in cardiac patients undergoing valve surgery.