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Updated: Aug 11, 2026
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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Vasoplegic Syndrome during Left Ventricular Assist Device Insertion: A Systematic Review and Meta-Analysis
Nicolas Kumar1, Jamel P Ortoleva2, Michael G Fitzsimons1
1Department of Anesthesiology, Mass General Brigham, Harvard Medical School, Boston, MA.
Journal of Cardiothoracic and Vascular Anesthesia
|August 4, 2026
Summary
Vasoplegic syndrome (VS) affects about one-third of patients receiving a durable left ventricular assist device (LVAD). Identifying risk factors like male sex and longer cardiopulmonary bypass times can improve patient outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Research
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
- Vasoplegic syndrome (VS) is a serious complication post-LVAD implantation.
- Understanding VS incidence and risk factors is vital for patient management.
Purpose of the Study:
- To determine the incidence of vasoplegic syndrome (VS) after durable left ventricular assist device (LVAD) implantation.
- To identify risk factors associated with VS development.
- To evaluate the clinical outcomes and mortality linked to VS.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Searched MEDLINE and EMBASE databases up to May 2026.
- Included 16 retrospective studies with 3,121 LVAD implantations and 1,093 VS cases.
Main Results:
- Pooled incidence of VS was 36.30%.
- Risk factors identified: male sex, INTERMACS profile ≤2, repeat sternotomy, concomitant procedures, and longer cardiopulmonary bypass (CPB) duration.
- VS correlated with increased right ventricular failure, renal replacement therapy, reoperation for bleeding, prolonged ICU stay, and higher 30-day and 1-year mortality.
Conclusions:
- Vasoplegic syndrome impacts approximately one-third of LVAD recipients.
- VS is linked to significantly increased postoperative morbidity and mortality.
- Identified risk factors enable preoperative risk stratification and targeted interventions.
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