Review Right Ventricular Failure in Cardiac Surgery and Intensive Care Medicine

Under normal conditions, because the right ventricle resembles a passive conduit rather than a pump, its physiology has been studied much less extensively than that of the left ventricle. Right ventricular failure has been recently identified as an important cause of progressive deterioration in patients with cardiac or cardiopulmonary dysfunction. Because the right and the left ventrictes are coupled in serially and mechanically, a pertorbation in one ventricle will influence the behavior of the other. Volume loading and pharmacologic interventions may have a limited effect in patients with severe right ventricular failure. Mechanical circulatory assistance may be required to sustain right heart function until the heart and lungs can recover. Recent advances in the technology of cardiopulmonary bypass have produced many advantages in the treatment of right ventricular failure after cardiac surgery and in critically ill patients who have not undergone cardiac surgery. In this article, the anatomy and the physiology of the right ventricle is reviewed and recent advances in the diagnosis and the treatment of right ventricuIar failure is discussed.