[Anaesthesia and right ventricular failure]

Abstract

Objective: The purpose of this review was to present an update of the anaesthesic management in patients with right ventricular failure (RVF).

Data sources: All references obtained from the medical database Medline related to the area and more specifically during the last five years were reviewed.

Data synthesis: The preanaesthesic visit leads to identify the etiology of RVF, to evaluate the functional reserve of the patient, to plan complementary exams and to inform the patients about the risks associated with the perioperative period. During the peroperative period, the monitoring depends of the severity of the illness; however the invasive monitoring of the systemic blood pressure seems always necessary. Any hemodynamic instability should be avoided during the peri-operative period. Since the risk of death is maximal in the first days after the anaesthesia, the patient is ideally managed in intensive care during this period.

Conclusion: Right ventricular failure is often mis-estimated. However, the perioperative morbidity and mortality of patients with RVF are important. In the perioperative period, the anaesthesiologist should identify patients at risk of right ventricular failure in order to adapt their management.