Right ventricular dysfunction following continuous flow left ventriccular assist device placement in 51 patients: predicators and outcomes

• Main Authors: Neragi-Miandoab Siyamek, Goldstein Daniel, Bello Ricardo, Michler Robert, D’Alessandro David
• Format: Article
• Language: English
• Published: BMC 2012-06-01
• Series: Journal of Cardiothoracic Surgery
• Subjects: right heart failure; congestive heart failure; septal function; tricuspid valve; regurgitation
• Online Access: http://www.cardiothoracicsurgery.org/content/7/1/60

<p>Abstract</p> <p>Background</p> <p>Right ventricular (RV) dysfunction following implantation of a left ventricular assist device (LVAD) is a serious condition and is associated with increased mortality.</p> <p>Methods</p> <p>The aim of the study is to investigate the significance of pre-existing RV dysfunction, tricuspid valve (TV) insufficiency, and the severity of septal deviation following LVAD implantation on RV dysfunction, as well as the outcome and short-term complications in 51 patients from June 2006 to August 2010. Student <it>t</it> test was used to compare the data and estimate the p value.</p> <p>Results</p> <p>Mean age was 55.1 ± 13, with a male to female ratio of 3.25. The 30-day mortality was 13.7% (7/51 patients), and the overall mortality was 23.5% (12/51 patients). Meanwhile, 21 patients (21/51; 41.2%) have undergone orthotopic heart transplantation. The mean time of support was 314.5±235 days with a median of 240 days at the time of closing this study. Echocardiographic evaluation of RV function pre- and post-implantation of an LVAD demonstrated septal deviation towards the left ventricle in immediate postoperative phase, which correlated with acute RV dysfunction (<it>p</it> = 0.002). Preoperative RV dysfunction was a significant predictor of postoperative right heart dysfunction following implantation of an LVAD (<it>p</it> = 0.001).</p> <p>Conclusion</p> <p>Preoperative RV dysfunction is a predictor of RV failure in LVAD patients. The adjustment of septal deviation through gradual increase of the LVAD flow can prevent the acute RV dysfunction following LVAD placement.</p>