BACKGROUND: Right @entity712 after cardiopulmonary bypass can result in severe hemodynamic compromise with high mortality, but the underlying mechanisms remain poorly understood. After @entity63 -induced @entity67 , alterations in the interventricular septal position decrease left ventricular compliance and limit filling but may also distort left ventricular geometry and compromise contractility and relaxation. This study investigated the effect of acute isolated right ventricular @entity63 on biventricular performance and interaction and the response of subsequent right ventricular unloading by use of a modified Glenn shunt. METHODS: In 8 @entity1707 isolated right @entity67 was induced by means of selective coronary ligation. A modified Glenn circuit was then established by a superior vena cava-pulmonary artery connection. Ventricular performance was determined by conductance catheter-derived right ventricular pressure-volume loops and left ventricular pressure-segment length loops. Hemodynamic data at baseline, after right ventricular @entity63 , and after institution of the Glenn circuit were obtained during inflow occlusion, and the load-independent contractile indices were derived. RESULTS: Right ventricular free-wall @entity63 resulted in acute right @entity2554 (118 +/- 81 mL vs 169 +/- 70 mL, P =.0008) and impairment of left ventricular contractility indicated by the reduced end-systolic pressure-volume relation slope (50.0 +/- 19 mm Hg/mm vs 18.9 +/- 8 mm Hg/mm, P =.002) and preload recruitable @entity64 work index slope (69.6 +/- 26 erg x cm(-3) x 10(3) vs 39.7 +/- 13 erg x cm(-3) x 10(3), P =.003). In addition, left ventricular relaxation (tau) was significantly prolonged (33.3 +/- 10 ms vs 53.0 +/- 16 ms, P =.012). Right ventricular unloading with the Glenn shunt reduced right @entity2554 and significantly improved left ventricular contraction, end-systolic pressure-volume relation slope (18.9 +/- 8 mm Hg/mm vs 35.8 +/- 18 mm Hg/mm, P =.002), preload recruitable @entity64 work index slope (39.7 +/- 26 erg x cm(-3) x 10(3) vs 63.0 +/- 22 erg x cm(-3) x 10(3), P =.003), and diastolic performance (tau 53.0 +/- 16 ms vs 43.5 +/- 13 ms, P =.001). CONCLUSIONS: Right ventricular @entity63 -induced dilation resulted in acute impairment of left ventricular contractility and relaxation. A modified Glenn shunt attenuated the left @entity67 by limiting right @entity2554 and restoring left ventricular cavity geometry.

Modified Glenn connection for acutely ischemic XXXX reverses secondary left ventricular dysfunction.

@entity1707 :: ('9823', 'Species') :: ['pigs'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity2554 :: ('MESH:C563906', 'Disease') :: ['ventricular dilation'] @entity67 :: ('MESH:D018754', 'Disease') :: ['ventricular ischemic failure', 'right ventricular failure', 'ventricular dysfunction']
@entity67 :: (MESH:D018754,Disease) :: ['right ventricular failure']
