Insuficiencia ventricular derecha en el seno de la cirugía cardiaca

Right ventricular failure after cardiac surgery remains an important clinical problem, especially in certain surgical settings: congenital heart disease, mitral valve disease with pulmonary hypertension, high-risk coronary artery disease, heart transplantation, pulmonary thromboendarterectomy and left ventricular assist device placement. In recent years, a number of studies have demonstrated the prognostic value of right ventricular function in cardiac surgery and, therefore, the usefulness of accurate risk stratification. The survival rate for acute, refractory, right ventricular failure after cardiac surgery may be as low as 20-25%. Less severe disease is also associated with increased postoperative morbidity and mortality and has a marked effect on the length of hospitalization. This highlights the importance of understanding the underlying pathophysiology of the condition, its clinical spectrum, early diagnosis and preventive strategies, all of which are discussed in this review article.