Right ventricular morphology and function after pulmonary resection

Objective: To identify the effect of pulmonary resection on right ventricul ar performance and its possible contribution to mortality and morbidity. Me thods: Before and 2 days after pulmonary resection for primary lung cancer in 31 patients (21 males; ages 32-69 years), echocardiographic examinations of the right ventricle were performed. Systolic, diastolic and stroke volu mes as well as right ventricular ejection fraction were estimated. Right ve ntricular volumes were calculated using the subtracting method. Results: Ri ght ventricular end-diastolic volume index increased significantly in patie nts after pneumonectomy: 80.4 +/- 7.2 ml/m(2) versus preoperative evaluatio n: 66.1 +/- 5.2 ml/m(2) (P = 0.031). In patients who underwent pneumonectom y right ventricular ejection fraction significantly decreased from 48 +/- 5 .0% preoperatively to 39% +/- 4.1% after surgery (P = 0.027). Fourteen pati ents after pneumonectomy had development of supraventricular arrhythmias po stoperatively. These patients had much higher right ventricular end-diastol ic volume index (76.3 +/- 6.4/82.1 +/- 7.4; P = 0.032) and lower right vent ricular ejection fraction (42 +/- 4.3/37 +/- 3.9; P = 0.021) after surgery in comparison with patients who had normal sinus rhythm postoperatively. Co nclusion: Pulmonary resection caused a significant dilatation and dysfuncti on of right ventricle in the early postoperative period. Early detection of deterioration in right ventricular function after pneumonectomy may provid e the opportunity for interventional therapy. (C) 1999 Elsevier Science B.V . All rights reserved.