Does Coronary Artery Bypass Grafting Surgery Affect the Right Ventricular Function Postoperatively?

Background A well-established benefit of coronary artery surgery (CABG) is to improve the left ventricular (LV) performance meanwhile, its impact on the right ventricular (RV) chamber is obscure and an issue of continuous investigations. Aim This study explores the influence of CABG on the RV performance. Methods This study employed a prospective longitudinal, observational design to evaluate function in 30 patients undergoing isolated CABG. Echocardiography with a transthoracic approach was accomplished preoperatively, one week and one-month post-surgery. The myocardial performance index (Tei index), tricuspid annular plane systolic excursion (TAPSE), and peak systolic (Sm) and early diastolic (Em) myocardial velocities at the sideways tricuspid annulus, derived from tissue doppler imaging (TDI)g, including measurement of the Q-Sm interval adapted to assess the RV. Results After CABG a decline in the right ventricle's ability to contract effectively (as shown by reduced TAPSE and Sm velocity) was observed, this decline persisted for at least one month. Shortly after surgery, there was also evidence of worsening overall RV function (increased Tei index). However, the surgery did not significantly affect the right ventricle's electrical activation and early relaxation. Conclusion CABG significantly impaired RV contractility, with severity associated with the left ventricular ejection fraction (LVEF), cardio-pulmonary bypass (CPB) duration, and coronary artery disease (CAD) extent, but no correlation was found between grafts, RCA lesions, and postoperative RV dysfunction. Keywords RV; CABG; performance; echocardiography; TAPSE. Key message CABG surgery can significantly impact the RV function, particularly in the short term.