Evaluation of right ventricular function after cardiac surgery: The importance of tricuspid annular plane systolic excursion and right ventricular ejection.

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Evaluation of right ventricular function after cardiac surgery: The importance of tricuspid annular plane systolic excursion and right ventricular ejection fraction Renata Garcia Gigorro, MD, PhD, Emilio Renes Carreño, MD, Sandra Mayordomo, MD, Helena Marín, MD, Jose Luis Perez Vela, MD, María Angélica Corres Peiretti, MD, Juan Carlos Montejo González, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 2, Pages 613-620 (August 2016) DOI: 10.1016/j.jtcvs.2016.04.041 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Measurement of TAPSE by M-mode cursor (discontinuous line) placed from the lateral annulus of the tricuspid valve (*) in the apical 4-chamber view. RV, Right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium; TAPSE, tricuspid annular plane systolic excursion. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Solid line shows a good correlation between TAPSE and RVEF. *P < .001. TAPSE, Tricuspid annular plane systolic excursion; RVEF, right ventricular ejection fraction. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Correlations between tricuspid annular plane systolic excursion and right ventricular ejection fraction after different surgical procedures. A, Heart transplant; B, pulmonary thromboendarterectomy; C, valve replacement; and D, coronary artery bypass graft. *P < .05, **P = .001. TAPSE, Tricuspid annular plane systolic excursion; RVEF, right ventricular ejection fraction. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Correlations between TAPSE (top) and RVEF (bottom) with preload and afterload parameters. mRAP, Mean right atrial pressure; TAPSE, tricuspid annular plane systolic excursion; mPAP, mean pulmonary artery pressure; PVRI, pulmonary vascular resistance index; RVEF, right ventricular ejection fraction. *P = NS, **P < .05, ***P < .001. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Correlation between tricuspid annular plane systolic excursion and right ventricular ejection fraction after cardiac surgery. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Apical 4-chamber view with M-mode cursor placed through the lateral annulus of the tricuspid valve. In this example, the TAPSE obtained was 9.15 mm, and the RVEF measurement in the same patient was 22%. TAPSE, tricuspid annular plane systolic excursion; RVEF, right ventricular ejection fraction. Video available at http://www.jtcvsonline.org/article/S0022-5223(16)30131-3/addons. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 613-620DOI: (10.1016/j.jtcvs.2016.04.041) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions