Early identification of right ventricular dysfunction and failure in cardiothoracic and liver surgical patients
This is prospective, non-interventional, observational study. The main purpose of this study is to develop an algorithm for the early detection of RV dysfunction/failure. The algorithm will be based on the RV pressure waveform gradients (the difference between early right ventricular diastolic pressure and end right ventricular diastolic pressure), RV end-diastolic pressure, and RV contractility (dpdt) and validated through associated clinical measures including perioperative mean arterial blood pressure, advanced hemodynamic measures like cardiac output, stroke volume and systemic vascular resistance, perioperative cerebral oximetry (a measure of cerebral perfusion), intraoperative transesophageal echocardiography and clinical outcomes. These associations will be used to train multiple mathematical models to discriminate between patients with and without RV dysfunction/failure as a primary endpoint. Examining the association between the slope of the diastolic right ventricular waveform (RV end-diastolic pressure, and RV contractility) and perioperative hemodynamics, TEE, cerebral saturation and clinical outcomes will allow us to estimate the specificity and sensitivity of our model.
Heart & Vascular