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Right Ventricular Failure After Left Ventricular Assist Device.

Rebecca Cogswell1, Ranjit John2, Andrew Shaffer2

  • 1Department of Medicine, Division of Cardiology, University of Minnesota, Variety Club Research Center (VCRC), 401 E. River Parkway, Minneapolis, MN 55455, USA.

Cardiology Clinics
|April 15, 2020
PubMed
Summary
This summary is machine-generated.

Right ventricular failure is common after left ventricular assist device (LVAD) implantation. Clear definitions are needed to improve treatment for advanced heart failure patients.

Keywords:
Heart failureRight ventricular functionVentricular assist devices

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Heart Failure Management

Background:

  • Right ventricular failure is a frequent complication following left ventricular assist device (LVAD) implantation, particularly in the current continuous-flow era.
  • The lack of standardized, consensus definitions for early and late right ventricular failure hinders research and clinical progress in advanced heart failure management.
  • Similarities in risk factors and physiological mechanisms exist between post-LVAD right ventricular failure and post-LVAD vasoplegia.

Purpose of the Study:

  • To highlight the unmet need for standardized definitions of right ventricular failure after LVAD implantation.
  • To underscore the shared pathophysiology between right ventricular failure and vasoplegia in the context of LVAD support.
  • To suggest potential therapeutic approaches for specific types of right ventricular dysfunction post-LVAD.

Main Methods:

  • Review of existing literature on right ventricular failure and vasoplegia in LVAD patients.
  • Analysis of shared risk factors and physiological pathways.
  • Discussion of current management strategies and the role of temporary mechanical support.

Main Results:

  • Right ventricular failure continues to be a significant challenge post-LVAD implantation.
  • Standardized definitions for right ventricular failure are crucial for advancing patient care.
  • Right ventricular vasoplegia, a form of relative right ventricular failure, shares etiological factors with primary RV failure post-LVAD.
  • Temporary right ventricular assist device support can be effective for managing right ventricular vasoplegia.

Conclusions:

  • Establishing clear, consensus-based definitions for right ventricular failure post-LVAD is essential for future research and clinical practice.
  • Recognizing the shared mechanisms between right ventricular failure and vasoplegia can inform treatment strategies.
  • Temporary right ventricular assist device support offers a viable option for managing right ventricular vasoplegia in the post-LVAD setting.