The Association of Pulmonary Artery to Aorta Diameter Ratio With Postoperative Outcomes Following Left Ventricular...

The authors aimed to study how the preoperative pulmonary artery to aorta (PA/Ao) diameter ratio in patients undergoing durable left ventricular assist device (LVAD) implantation relates to the duration of inotropic therapy, as well as length of stay (LOS) in the intensive care unit (ICU) and hospital. They hypothesized that the PA/Ao diameter ratio would be associated with longer durations of postoperative inotropic therapy, ICU LOS, and hospital LOS (HLOS).

Retrospective observational study between July 2012 and December 2019.

Single-center study at a quaternary care academic center.

Adults (aged > 18 gt; 18 years) who have undergone LVAD implantation.

LVAD implantation.

One hundred fifty-nine patients were evaluated. A larger PA/Ao diameter ratio was associated with increased inotrope duration (odds ratio [OR], 28.80; 95% confidence interval [CI], 10.56-78.55; p < 0.0001), ICU LOS (OR, 2.86; 95% CI, 1.29-6.33; p < 0.03), and HLOS (OR, 2.96; 95% CI, 1.21-7.26; p = 0.02). The PA/Ao diameter ratio showed significant moderate positive correlations with clinical outcomes. Specifically, each 0.04-, 0.08-, and 0.06-unit increase in the ratio was associated with 1 additional day of inotropic therapy, a 1-day increase in ICU LOS, and a 1-day increase in HLOS, respectively.

The findings support the hypothesis that larger PA/Ao diameter ratios are associated with increased durations of postoperative inotropic support, ICU LOS, and HLOS. The PA/Ao diameter ratio may be a valuable risk assessment tool in patients undergoing LVAD implantation.