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Right ventricular (RV) failure after cardiac surgery is associated with morbidity and mortality, but is hard to diagnose with conventional echocardiographic means. RV dysfunction may be associated with hepatic congestion, which may have an effect on portal veinous flow, but this has not been extensively. The investigators aimed determine whether an increased pulsatility in the portal venous flow was associated with RV dysfunction, after cardiac surgery at risk of RV dysfunction: mitral and tricuspid valve procedures.
In cardiac surgical patients, RV dysfunction is associated with organ hypoperfusion and venous congestion leading to increased morbidity and mortality.
Non-invasive methods used to assess RV function are 2D-echocardiographic measurement of tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (EF), RV fractional area change (FAC), 3D assessment of RV function, tissue Doppler assessment of velocities, and magnetic resonance imaging (MRI). Though MRI is the gold standard method to assess RV function, it cannot be used in the perioperative period.
In the present prospective observational study, The investigators investigated the association between the pattern of portal venous flow and RV function as assessed by echocardiography in the postoperative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adults patients undergoing mitral and / or tricuspid valve surgery with cardiopulmonary bypass. | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cardiac surgery involving mitral or tricuspid valve repair procedure, with cardiopulmonary bypass | Other | cardiac surgery involving mitral or tricuspid valve repair procedure, with cardiopulmonary bypass |
| Measure | Description | Time Frame |
|---|---|---|
| Right ventricular failure |
| First 24 hours post cardiac surgery |
| Portal flow measured by Doppler | flow pulsatility is assessed with the formula = 100 x (Vmax-Vmin)/Vmax. Time frame: First 24 hours post cardiac surgery | First 24 hours post cardiac surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Echocardiographic acquisition | Feasability of all measurements (RV failure with the 4 criteria:
| First 24 hours post cardiac surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CMC Ambroise Paré | Neuilly-sur-Seine | 92200 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19151265 | Background | Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: II. Pathophysiology, clinical importance, and management. Anesth Analg. 2009 Feb;108(2):422-33. doi: 10.1213/ane.0b013e31818d8b92. | |
| 19151264 | Background | Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: I. Anatomy, physiology, and assessment. Anesth Analg. 2009 Feb;108(2):407-21. doi: 10.1213/ane.0b013e31818f8623. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | May 14, 2026 | |
| Reset | Jun 9, 2026 |
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| Echocardiographic acquisition | Feasability of all measurements (RV failure with the portal flow with Doppler) | First 24 hours post cardiac surgery |
| Concordance of pulsatile flow assessment | Concordance of repeated measurements of the venous portal flow Time frame: First 24 hours post cardiac surgery | First 24 hours post cardiac surgery |
| Concordance of RV dysfunction measurements | Concordance of repeated measurements of :
| First 24 hours post cardiac surgery |
| Preoperative RV dysfunction | As defined
| 30 days before cardiac surgery |
| Acute kidney injury | defined by KDIGO criteria as creatininemia elevation above > 26 micromol/L during the first 48 hours or +50% during the first week, oliguria with urine output less than 0.5 mL/kg/h during 6 hours. | one week after surgery |
| Cholestasis | Conjugate bilirubin elevation above 12 mmol/L | one week after surgery |
| 28151822 | Background | Denault AY, Beaubien-Souligny W, Elmi-Sarabi M, Eljaiek R, El-Hamamsy I, Lamarche Y, Chronopoulos A, Lambert J, Bouchard J, Desjardins G. Clinical Significance of Portal Hypertension Diagnosed With Bedside Ultrasound After Cardiac Surgery. Anesth Analg. 2017 Apr;124(4):1109-1115. doi: 10.1213/ANE.0000000000001812. |
| 20620859 | Background | Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010 Jul;23(7):685-713; quiz 786-8. doi: 10.1016/j.echo.2010.05.010. No abstract available. |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| May 14, 2026 | Jun 9, 2026 |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D006331 | Heart Diseases |
| D006333 | Heart Failure |
| D006349 | Heart Valve Diseases |
| D018497 | Ventricular Dysfunction, Right |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002318 | Cardiovascular Diseases |
| D018754 | Ventricular Dysfunction |
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