Author/Authors :
Chinikar, Madjid Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Rafiee, Mohammad Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Aghajankhah, Mohammadreza Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Gholipour, Mahboobeh Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Hasandokht, Tolou Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Imantalab, Vali Anesthesiology Research Center - Guilan University of Medical Sciences, Rasht, Iran , Mirmansouri, Ali Anesthesiology Research Center - Guilan University of Medical Sciences, Rasht, Iran , Mohammadzadeh, Ali Anesthesiology Research Center - Guilan University of Medical Sciences, Rasht, Iran , Nassiri-Sheikhani, Nassir Department of Cardiac Surgery - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Naghshbandi, Mona Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Pourabdollah, Mahsa Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Rezaee, Mohammad Esmaeil Department of Cardiology - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Sedighinejad, Abbas Anesthesiology Research Center - Guilan University of Medical Sciences, Rasht, Iran , Sadeghi-Meibodi, Alimohammad Department of Cardiac Surgery - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran , Dadkhah-Tirani, Heidar Department of Cardiac Surgery - School of Medicine - Guilan University of Medical Sciences, Rasht, Iran
Abstract :
BACKGROUND: Coronary artery bypass grafting (CABG) surgery is widely accepted as a
revascularization method for coronary artery disease (CAD). Despite survival benefit and
improvement in quality of life, CABG may impose major morbidities and significant
complications. Right ventricle (RV) dysfunction is an important complication that may affect
patient's longevity and functional capacity. The aim of this study was to evaluate the
relationship between RV dysfunction and some invisible parameters like inferior vena cava
(IVC) size with physical capacity.
METHODS: In this prospective study, 61 eligible CABG candidates were enrolled and RV
function was assessed by echocardiographic parameters before CABG and one week and six
months after the procedure, using tricuspid annular plane systolic excursion (TAPSE), Tei Index
(TI), peak systolic movement (Sm) (cm/s), and IVC size. Functional capacity was assessed by
six-minute walk test (6-MWT) 6 months after CABG.
RESULTS: 58 patients who did not have any perioperative RV dysfunction were remained until
the end of study; mean age was 58.2 ± 7.9 years with 68.9% being men, and 3 patients died after
CABG. Preoperatively, septal motion, RV indices, and IVC size were normal in all patients. The
frequency of RV dysfunction according to abnormal TAPSE index, TI, and peak Sm one week
after surgery was 81.0%, 79.0%, and 62.0%, respectively, and 6 months after surgery was 49.0%,
49.0%, and 37.0%, respectively. Mean walked distance in 6-MWT was significantly less in
patients with RV dysfunction, older age, and higher number of involved vessels (P < 0.001).
CONCLUSION: The significant reduction in RV function and impairment of exercise capacity
after CABG in this study suggests cardiologists to pay more attention to RV assessment in
follow-up visits of patients undergoing GABG.
