Importance of right ventricular function after cardiac transplantation

Importance of right ventricular function after cardiac transplantation

Right ventricular function after cardiac transplantation: Right ventricular function assessment is quite important in recipients of orthotopic cardiac transplant. Right ventricular dilatation and failure can occur in early postoperative period as a result of elevated pulmonary vascular resistance. Early recognition makes the treatment of this situation feasible with inhaled nitric oxide therapy. On the other hand, under recognition and lack of treatment can lead on to progressive deterioration of right ventricular function and sometimes early mortality. Even in those who eventually improve, residual right ventricular dysfunction may occur. S W Kendall, H B Bittner, D S Peterseim, K A Campbell and P Van Trigt [1] have noted that right ventricular myocardial injury can be related to donor brain death. Another important consideration in the transplanted heart is the likelihood of tricuspid regurgitation as the most common valvular lesion in the transplanted heart.

Brian R White, Hannah Katcoff, Jennifer A Faerber, Kimberly Y Lin, Joseph W Rossano, Laura Mercer-Rosa and Matthew J O’Connor [2] assessed the right ventricular function of clinically well pediatric heart transplant patients. They were found to have significantly decreased quantitative measures of right right ventricular function compared to controls.

The measurements of right ventricular systolic function assessed were tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and peak systolic tricuspid annular tissue velocity (S’) [2].

References

1. S W Kendall, H B Bittner, D S Peterseim, K A Campbell, P Van Trigt. Right ventricular function in the donor heart. Eur J Cardiothorac Surg. 1997 Apr;11(4):609-15.
2. Brian R White, Hannah Katcoff, Jennifer A Faerber, Kimberly Y Lin, Joseph W Rossano, Laura Mercer-Rosa Matthew J O’Connor. Echocardiographic Assessment of Right Ventricular Function in Clinically Well Pediatric Heart Transplantation Patients and Comparison With Normal Control Subjects. J Am Soc Echocardiogr. 2019 Apr;32(4):537-544.e3.