Protection of the right heart

Abstract

Until recently, right ventricular failure (RVF) was a relatively neglected medical condition. The right ventricle was considered as a moderately passive conduit between the systemic and pulmonary circulations. This belief was supported by studies showing that complete destruction of the right ventricular free wall in dogs had no detectable impairment on overall cardiac performance (Starr et al.). However, precipitating factors for right ventricular failure are common in the clinical praxis of cardiothoracic surgery and intensive care medicine. These include increased pulmonary resistance, such as after cardiac transplantation, acute respiratory distress syndrome, the presence of left ventricular assist device, positive pressure mechanical ventilation and sepsis. Therefore it can be speculated that there is a higher incidence of right ventricular failure than generally recognized. © 2011 Springer-Verlag/Wien.