Comparative evaluation of right ventricular function after coronary artery bypass grafting and percutaneous coronary intervention to RCA / Deena Abdulmoez Mustafa ; Supervised Wael M. Elnaggar , Yehia Balbaa , Zainab A. Ashour

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Assessment of the right ventricle for clinical purposes including diagnosis, prognosis and response to therapeutics has been challenging. Decreased right ventricle function has been proposed after coronary artery bypass graft. The exact underlying mechanism leading to right ventricle dysfunction is still unknown. Hypothesis: Right ventricular function is not affected after percutaneous coronary intervention to right coronary artery while it is affected after coronary artery bypass graft including graft to right coronary artery.Objective: Comparative evaluation of right ventricle function using tissue Doppler just before and at 3 month after intervention to right coronary artery and coronary artery bypass graft including graft to right coronary artery. Patients and methods: This is a prospective study that enrolled 50 patients who were electively scheduled for right coronary artery revascularization in Dar Al Fouad Hospital from August 2013 to January 2015. We included all patients who had stable or unstable angina pre-diagnosed with right coronary stenosis. Assessment of the right ventricle function was done using TAPSE, S{u2019} wave velocity TDI, fractional area change (FAC) and global longitudinal strain by speckle tracking. Results: Mean age of the coronary artery bypass graft (CABG) patients was 60±10 years (92% males and 88% had ejection fraction >55%), as for the Percutaneous coronary intervention (PCI) group mean age was 56±8 years (96% males and 84% had EF > 55%). For the CABG group all right ventricular systolic function parameters were significantly reduced after follow up, FAC was reduced from from median 53% to 45% P value <0001, TAPSE was reduced from median 2.2cm to 1.3cm P value <0001, S{u2019} wave velocity was reduced from median 14cm/s to 9cm/s P value < 0.0001 and the global longitudinal strain by 2D speckle tracking was reduced from -19% to -11.7% P value <0.0001

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