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Published on: August 16, 2021
Left ventricular assist devices and right heart dysfunction: a review of impact mechanisms, evaluation methods, and
Zhiwei Fan1, Pengyu Zhou2, Shiliang Li3
1Department of Pharmacy, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, 225300, Jiangsu Province, PR China.
Background:
Left ventricular assist devices (LVADs) have become an important treatment option for patients with end-stage heart failure, significantly improving left ventricular function and patient survival rates. However, LVAD implantation has complex effects on right heart function, and right heart dysfunction is a critical factor affecting patient prognosis and quality of life.
Methods:
This article systematically reviews the relationship between LVADs and right heart function, focusing on the importance of right heart function in LVAD patients, evaluation methods, impact mechanisms, and prevention and management strategies. Additionally, it introduces emerging technologies and future research directions to provide references for clinical practice.
Results:
Studies have shown that comprehensive evaluation of right heart function is crucial for predicting the risk of postoperative right heart dysfunction. The impact mechanisms of LVAD implantation on right heart function are complex, including changes in preload and afterload and ventricular interdependence. Prevention and management of right heart dysfunction require comprehensive measures, including preoperative optimization, meticulous intraoperative procedures, close postoperative monitoring, and multidisciplinary team collaboration. Emerging technologies such as improved LVAD designs, biventricular assist devices, gene therapy, and personalized medicine offer new hope for reducing the incidence of right heart dysfunction.
Conclusion:
Right heart function holds undeniable importance in LVAD therapy. Through comprehensive evaluation, prevention, and management of right heart function, as well as the application of new technologies, it is expected to reduce the incidence of right heart dysfunction and improve the prognosis and quality of life of LVAD patients. More high-quality research is needed in the future to promote the clinical application of emerging technologies and provide more comprehensive treatment options for patients with end-stage heart failure.
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