Right Ventricular Failure and Biventricular Support Strategies.

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Devices

Background:

• Right ventricular (RV) dysfunction is prevalent in advanced heart failure patients evaluated for left ventricular assist device (LVAD) implantation.
• RV dysfunction can significantly impact outcomes following LVAD surgery.

Purpose of the Study:

• To outline critical factors for assessing RV function before LVAD implantation.
• To detail perioperative management strategies for preventing RV dysfunction.
• To discuss temporary and permanent RV support options, including challenges with using LVADs for RV support.

Main Methods:

• Review of current literature and clinical guidelines on RV assessment and management in the context of LVADs.
• Discussion of perioperative strategies and RV support modalities.

Main Results:

• Comprehensive RV assessment is crucial prior to LVAD surgery.
• Proactive perioperative management can mitigate RV dysfunction.
• Various temporary and permanent RV support options exist, with specific considerations for off-label LVAD use in the right ventricle.

Conclusions:

• Optimizing RV assessment and management is essential for successful LVAD implantation in patients with advanced heart failure.
• Careful consideration of RV support strategies, including potential LVAD application, is necessary to improve patient outcomes.