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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Predicting, Recognizing, and Treating Right Heart Failure in Patients Undergoing Durable LVAD Therapy
Teresa S Wang1, Marisa Cevasco2, Edo Y Birati3
1Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Journal of Clinical Medicine
|June 10, 2022
Summary
Right heart failure is a major concern after left ventricular assist device (LVAD) implantation, especially in sicker patients receiving destination therapy. Understanding and managing this condition is crucial for successful LVAD outcomes.
Area of Science:
- Cardiovascular Surgery
- Heart Failure Management
- Mechanical Circulatory Support
Background:
- Right heart failure (RHF) is a significant cause of morbidity and mortality following left ventricular assist device (LVAD) implantation.
- Changes in United Network for Organ Sharing (UNOS) allocation policies have led to an increase in destination therapy LVADs, comprising a sicker patient population.
- A thorough understanding of RHF post-LVAD is essential for improving long-term device success.
Purpose of the Study:
- To elucidate the impact of LVAD implantation on right heart function.
- To review diagnostic and predictive criteria for identifying RHF in LVAD patients.
- To discuss current management and treatment strategies for post-LVAD RHF.
Main Methods:
- This is a review article.
- Literature search and synthesis of existing evidence on RHF after LVAD implantation.
- Analysis of diagnostic tools, predictive factors, and therapeutic interventions.
Main Results:
- LVAD implantation can significantly alter right heart hemodynamics and function.
- Specific diagnostic criteria and predictive models for RHF are being developed and refined.
- Evidence for management strategies, including medical and mechanical interventions, is evolving.
Conclusions:
- Post-LVAD RHF remains a critical clinical challenge requiring comprehensive understanding and tailored management.
- Continued research is needed to optimize the diagnosis and treatment of RHF in LVAD recipients.
- Effective management of RHF is paramount for enhancing survival and quality of life in patients with durable LVADs.
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