The apical displacement of tricuspid valve leaflets complicated with significantly enlarged, thin and fibrotic wall of the right ventricle is prone to dysfunction of right heart. Therefore, the myocardial protection for the right ventricle is important. Based on the pathological changes, an algorithm of perioperative myocardial protection strategy is summarized. Firstly, we should clearly know that the right ventricular myocardium with severe lesions is much different from the unimpaired myocardium, because it is now on the margin of failure; secondly, right heart protection should be regarded as a systematic project, which runs through preoperative, intraoperative and postoperative periods, and requires close collaboration among surgeons, perfusionists, anesthesiologists and ICU physicians. In this article, we try to introduce the systematic project of the right heart protection, in order to improve the outcome of this population.
Quality control of cardiopulmonary bypass (CPB) in clinic is key to keep patients’ safety. In recent years, a quality control system for CPB is well developed in West China Hospital, including a monitoring part and a clinical management. After 5 years of its implementation, it has been shown that this system not only ensures patients’ safety but also enhances the quality of CPB, reducing the incidence of CPB-related complications and improving the prognosis. This article will introduce in details the implementation and standards of this clinical quality control system. We believe the system may help establish CPB quality control standards in China.