- Meeting abstract
- Open Access
1012 Cardiac surgery results in anterior translocation of the left ventricle in systole and tethering of the right ventricular free wall – an explanation for post-operative paradoxical septal motion
© Joshi et al; licensee BioMed Central Ltd. 2008
- Published: 22 October 2008
- Cardiac Magnetic Resonance
- Cardiac Magnetic Resonance Imaging
- Ventricular Free Wall
- Septal Motion
- Short Axis Cine
Abnormal (paradoxical) interventricular septal motion is commonly noted on echocardiography after cardiac surgery. Its mechanism has been debated. Cardiac magnetic resonance imaging (MRI) allows for accurate assessment of movement of the heart relative to the chest wall.
To compare the motion of cardiac structures pre and post cardiac surgery.
Patients scheduled for coronary artery bypass surgery were prospectively enrolled to undergo cardiac MRI before and three months after surgery. On a mid left ventricular (LV) short axis cine image the positions of myocardial landmarks were ascertained relative to a stationary anterior reference point. Systolic wall thickening (SWT) in the mid septum was assessed on the same images. Viability images and echocardiography results were also reviewed.
Motion in Systole, + Anterior, - Posterior
RV wall (mm)
Mid LV cavity (mm)
Lateral LV wall (mm)
Septal SWT (%)
After cardiac surgery the entire left ventricle moves anteriorly in systole. There is reduced motion of the right ventricular free wall suggestive of tethering to chest wall. This pattern of movement post-operatively occurs despite preserved septal wall thickening and improved global left and right ventricular function.
This article is published under license to BioMed Central Ltd.