Ecocardiographical investigation for effects of pulmunary resection on cardiac function

Although the history of the pulmonary resections goes back to about 500 years, safe and successful resections have been performed for the second part of the 20th century. With development of preoperative assestment methods and postoperative care the reduced morbidity and mortality have been seen. Echocardiography is a useful tool in the investigation of the morphological and functional changes of the heart following either a lobectomy, or a pneumonectomy operation.This study was designed to evaluate the effect of the major pulmonary resections including lobectomy and pneumonectomy on the heart using an echocardiography.Sixteen patients who was hospitalized in the clinic of Thoracic Surgery of Firat University medical Faculty, underwent a major pulmonary resection were included into the study. These patients were grouped into two according to the surgical procedure (lobectomy or pneumonectomy). For each patients, the blood gas analysis, the respiratory function test, and an echocardiography were performed just before the operation (preoperative) and sixth month after the operation (postoperative).Compared with the preoperative values, the postoperative values for both FEV1 and FVC were significantly lower in both groups (p<0.05). There were no differences in the PaO2 and PaCO2 level, either pre- or postoperatively, in both groups (p>0.05). In the lobectomy group, the surgery caused no significant changes in both left and right heart functions and pressures in the postoperative period (p>0.05). The same result was obtained in the left heart measurements following the pneumonectomy (p>0.05), but six months after the surgery, the pulmonary arterial pressure (preoperative 27.80±11.10, postoperative 33.20±8.10, p=0.011), the diameter of the right ventricle (preoperative 22.40±0.78, postoperative 24.50±1.81, p=0.011), and the velocity of the tricuspid valve (preoperative 2.08±0.57, postoperative 2.37±0.42, p=0.010) were significantly increased.Compared with cardiac catheterisation and radionuclide ventriculography, echocardiography is a more efficient, cheap, and non-invasive method in the evaluation of the cardiac functions. A thoracic surgeon should avoid a pneumonectomy as much as possible, since the procedure causes more changes in the right ventricle modifications.Keywords: Pneumonectomy, right ventricle, echocardiography