Outcome and Definition of Right Ventricular Dysfunction
The outcome was RVD, which was defined as the presence of severe right
ventricular dilation and interventricular septal flattening (determined
qualitatively by the clinician performing TTE). Tricuspid annular plane
systolic excursion(TAPSE) is easily obtainable and is a measure of RV
longitudinal function. TAPSE<16 mm indicates RV systolic
dysfunction[9]. Anatomical M-mode was applied on
the focused apical 4-chamber view of the RV to measure TAPSE. Heart
failure that required inotropes for left heart failure with elevated
pulmonary capillary wedge pressure(PCWP) or pulmonary congestion caused
by inadequate LVAD pump speed or aortic valve insufficiency was not
considered RVD. Preoperative moderate FTR was not surgically treated
when the MVR was implanted and was controlled preoperatively with
specific medication for HF, volume optimization and medication to
decrease pulmonary vascular resistance if PH was present.