Femoral Venous Pulsatility and Right Heart Dysfunction in Heart Surgery: An Observational Study

Femoral Venous Pulsatility and Right Heart Dysfunction in Heart Surgery: An Observational Study

Right heart failure during cardiac surgery is associated with increased perioperative morbidity and mortality. In this context, it is imperative to develop simple diagnostic tools to detect right heart failure. The purpose of this observational study is to determine if ultrasound Doppler of the femoral vein can detect and predict right ventricular failure after cardiac surgeries requiring cardiopulmonary bypass. It is expected that an elevated pulsatility of the femoral vein before the induction of general anesthesia is associated with perioperative right heart failure.

Inclusion Criteria:

• Adults (at least 18 years old)
• Able to consent
• Undergoing elective cardiac surgery at the Montreal Heart Institute
• Surgery requiring cardiopulmonary bypass
• Peri-operative trans-oesophageal echography planned

Exclusion Criteria:

• Critical preoperative state, defined as vasopressor requirement, mechanical support including intra-aortic balloon, mechanical ventilation or cardiac arrest necessitating resuscitation
• Know condition that could interfere with femoral venous assessment or interpretation (such as femoral vein thrombosis, femoral instrumentation, ECMO, etc.)
• Planned cardiac transplantation, implantation of a ventricular assist device or surgery for a congenital condition
• Pregnancy