To assess the right ventricular function using transesophageal echocardiogram before and after coronary ypass surgery

Over the years the focus has shifted from Left ventricular to right ventricular function because of the growing evidence of Right ventricular Dysfunction following cardiac surgeries. Right ventricular dysfunction following cardiac surgery is associated with high mortality and morbidity. A decrease in RV function can occur during or immediately after cardiac surgery. Though the mechanism of RV dysfunction is not known, few studies have suggested impaired diastolic function of the right ventricle as one of the major cause of hemodynamic derangements observed during the surgery, other complications are related to poor right sided myocardial preservation with retrograde cardioplegia, increased afterload following cardiopulmonary bypass and air embolism during de airing in on pump coronary artery bypass graft surgery, while there are limited data on RV dysfunction in patients undergoing off pump coronary artery bypasss grafting surgery. Perioperative assessment of RV function is complex and achieved using different parameters. Though the qualitative assessment has good sensitivity it is less specific in terms of differentiation between normal and abnormal RV function. Guidelines of Echocardiographic assessment of Right Ventricle have suggested assessment of atleast FAC ( fractional Area Change), S’, TAPSE( tricuspid annular plane systolic excursion) with or without RV index of myocardial performance.Our study aims to assess change in RV systolic function during CABG surgery using following parameters TAPSE and FAC