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Echocardiographic Investigation of the Mechanism Underlying Abnormal Interventricular Septal Motion after Open Heart Surgery

 Min-Kyung Kang  ;  Hyuk-Jae Chang  ;  In Jeong Cho  ;  Sanghoon Shin  ;  Chi-Young Shim  ;  Geu-Ru Hong  ;  Kyung-Jong Yu  ;  Byung-Chul Chang  ;  Namsik Chung 
 Journal of Cardiovascular Ultrasound, Vol.22(1) : 8-13, 2014 
Journal Title
Journal of Cardiovascular Ultrasound
Issue Date
Coronary artery bypass ; Echocardiography ; Valve surgery ; Ventricular septum
BACKGROUND: Abnormal interventricular septal motion (ASM) is frequently observed after open heart surgery (OHS). The aim of this study was to investigate the incidence and temporal change of ASM, and its underlying mechanism in patients who underwent OHS using transthoracic echocardiography (TTE). METHODS: In total, 165 patients [60 ± 13 years, 92 (56%) men] who underwent coronary bypass surgery or heart valve surgery were consecutively enrolled in a prospective manner. TTE was performed preoperatively, at 3--6-month postoperatively, and at the 1-year follow-up visit. Routine TTE images and strain analysis were performed using velocity vector imaging. RESULTS: ASM was documented in 121 of 165 patients (73%) immediately after surgery: 26 patients (17%) presented concomitant expiratory diastolic flow reversal of the hepatic vein, 11 (7%) had inferior vena cava plethora, and 11 (7%) had both. Only 2 patients (1%) showed clinically discernible constriction. ASM persisted 3--6 months after surgery in 38 patients (25%), but only in 23 (15%) after 1 year. There was no difference in preoperative and postoperative peak systolic strain of all segments of the left ventricle (LV) between groups with or without ASM. However, systolic radial velocity (VRad) of the mid anterior-septum and anterior wall of the LV significantly decreased in patients with ASM. CONCLUSION: Although ASM was common (74%) immediately after OHS, it disappeared over time without causing clinically detectable constriction. Furthermore, we consider that ASM might not be caused by myocardial ischemia, but by the decreased systolic VRad of the interventricular septum after pericardium incision.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Min Kyung(강민경)
Shin, Sang Hoon(신상훈)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Chang, Byung Chul(장병철)
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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