Related Experiment Videos
Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem
Minoo N Kavarana1, Melissa S Pessin-Minsley, Jacqueline Urtecho
1Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
The Annals of Thoracic Surgery
|March 20, 2002
Summary
Right ventricular dysfunction (RVD) in left ventricular assist device (LVAD) recipients is often unrecognized and linked to increased complications. Early identification of RVD risk factors is crucial for better patient outcomes.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Devices
Background:
- Right ventricular dysfunction (RVD) remains a significant concern in patients undergoing left ventricular assist device (LVAD) implantation, despite advances in medical therapy.
- The use of right ventricular assist devices (RVADs) has decreased, but RVD complicates LVAD therapy.
Purpose of the Study:
- To retrospectively analyze the incidence and outcomes of RVD in LVAD recipients.
- To identify risk factors associated with RVD in this patient population.
Main Methods:
- Retrospective analysis of 69 patients who received Thoratec Vented Electrical LVADs between June 1996 and September 1999.
- RVD was defined by prolonged inotropic support or the need for RVAD implantation.
Main Results:
- Twenty-one patients (30.4%) experienced RVD.
- RVD was associated with higher preoperative bilirubin, postoperative creatinine, increased need for continuous venovenous hemofiltration dialysis, and higher transfusion requirements for red blood cells and platelets.
- Patients with RVD had significantly longer intensive care unit and hospital stays, and a markedly higher mortality rate (42.8% vs. 14.5%).
Conclusions:
- Right ventricular dysfunction in LVAD recipients is underdiagnosed and associated with severe complications, including end-organ failure, prolonged hospitalization, and increased mortality.
- Identifying preoperative risk factors for RVD is essential for patient selection and may guide the decision for biventricular assist device support to prevent adverse outcomes.