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Volume 3 Supplement 1


Right ventricular ejection fraction in postoperative cardiac surgery patients is independently associated with ICU morbidity and mortality

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Left ventricular heart failure is a well-known risk factor in cardiac surgery. However, data on the clinical relevance of right ventricular (RV) failure are limited.1


To establish the prognostic implications of RV failure in a large series of post cardiac surgery patients.


We performed a single-centre retrospective analysis of all high risk cardiac surgery patients in a four year period. By protocol these patients were equipped with a pulmonary artery catheter (Vigilance®, Baxter), enabling continuous RV ejection fraction (RVEF) measurements. RVEF was categorized into three subgroups: RVEF < 20%, 20-30% and >30%. Demographic data and hemodynamic variables were recorded. Primary outcome was predefined as the correlation between the average RVEF over the first 24 hours in the ICU and markers of morbidity.


A total of 1115 patients were included. Patient characteristics are summarized in table 1. Patients with an RVEF < 20% had a significant longer duration of mechanical ventilation and lengths of stay in the ICU, higher ICU mortality, and increased use of inotropes and fluids. In a multivariate logistic regression model, RVEF appeared to be an independent risk factor for duration of mechanical ventilation, length of stay ICU, and ICU mortality.


Figure 1

Table 1 Baseline characterstics.
Table 2 Outcome.


A RVEF < 20% is independently associated with increased ICU mortality and morbidity in high risk postoperative cardiac surgery patients.


  1. 1.

    Haddad F, et al: The Right Ventricle in Cardiac Surgery, a Perioperative Perspective: II. Pathophysiology, Clinical Importance, and Management. Anesthesia & Analgesia. 2009, 108: 422-33. 10.1213/ane.0b013e31818d8b92.

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Correspondence to IT Bootsma.

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  • Right Ventricular
  • Pulmonary Artery Catheter
  • Right Ventricular Ejection Fraction
  • Right Ventricular Failure
  • Ventricular Heart