Right heart failure after durable left ventricular assist device implantation

Area of Science:

• Cardiology
• Mechanical Circulatory Support

Background:

• Right heart failure (RHF) is a significant complication following left ventricular assist device (LVAD) implantation.
• RHF is associated with increased morbidity and mortality in LVAD patients.

Purpose of the Study:

• To review current definitions and mechanisms of RHF post-LVAD.
• To explore available medical and device therapies for managing RHF.
• To highlight knowledge gaps and areas for future research in RHF after LVAD.

Main Methods:

• Literature search conducted on PubMed from 2010 to 2023.
• Review of existing definitions, mechanisms, and therapies for RHF in the context of LVAD.

Main Results:

• RHF remains a frequent complication after LVAD implantation.
• Current risk stratification tools for RHF have limited clinical applicability and poor performance.
• There are significant knowledge gaps in adequately addressing RHF consequences.

Conclusions:

• Early identification and management of RHF are critical for improving outcomes.
• Further investigation is needed to enhance identification and develop targeted therapies for post-LVAD RHF.
• Improving RHF management holds potential for significant patient outcome improvements.