Management of Right Heart Failure after Cardiac Surgery

Perioperative right heart failure(RHF) is an important problem, especially in the field of heart failure surgery. Right ventricular performance is determined by the combination of preload, contractility, heart rate, rhythm and afterload. Many factors influence on these parameters in the perioperative period, and the deterioration of one of them can cause RHF. Recently, we often encounter perioperative RHF after left ventricular assist device (LVAD) implantation, and prompt LVAD pump speed optimization and treatment for RHF is required to avoid complications and hemodynamic deterioration. Concomitant tricuspid annulus plasty may be effective for selected patients. In this review, we show the factors determining the performance of right ventricle, and then summarize the etiology and management strategies of perioperative RHF.