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https://doi.org/10.3325/cmj.2014.55.587

Predictors of right ventricular failure after left ventricular assist device implantation

Marijan Koprivanac ; 1Heart and Vascular Institute,Department of Thoracic andCardiovascular Surgery, ClevelandClinic, Abu Dhabi, United ArabEmirates
Marta Kelava ; Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
Franjo Sirić ; Division of CardiothoracicSurgery, University of Alabama atBirmingham, Birmingham, AL, USA
Vincent B. Cruz ; Cleveland Clinic Lerner College of Medicine of Case Western ReserveUniversity School of Medicine,Cleveland, OH, USA
Nader Moazami ; 1Heart and Vascular Institute,Department of Thoracic andCardiovascular Surgery, ClevelandClinic, Abu Dhabi, United Arab Emirates
Tomislav Mihaljević ; 1Heart and Vascular Institute,Department of Thoracic andCardiovascular Surgery, ClevelandClinic, Abu Dhabi, United Arab Emirates


Puni tekst: engleski pdf 702 Kb

str. 587-595

preuzimanja: 711

citiraj


Sažetak

Number of left ventricular assist device (LVAD) implantations
increases every year, particularly LVADs for destination
therapy (DT). Right ventricular failure (RVF) has been recognized
as a serious complication of LVAD implantation. Reported
incidence of RVF after LVAD ranges from 6% to 44%,
varying mostly due to differences in RVF definition, different
types of LVADs, and differences in patient populations
included in studies. RVF complicating LVAD implantation
is associated with worse postoperative mortality and morbidity
including worse end-organ function, longer hospital
length of stay, and lower success of bridge to transplant
(BTT) therapy. Importance of RVF and its predictors in a
setting of LVAD implantation has been recognized early, as
evidenced by abundant number of attempts to identify independent
risk factors and develop RVF predictor scores
with a common purpose to improve patient selection and
outcomes by recognizing potential need for biventricular
assist device (BiVAD) at the time of LVAD implantation. The
aim of this article is to review and summarize current body
of knowledge on risk factors and prediction scores of RVF
after LVAD implantation. Despite abundance of studies and
proposed risk scores for RVF following LVAD, certain common
limitations make their implementation and clinical
usefulness questionable. Regardless, value of these studies
lies in providing information on potential key predictors
for RVF that can be taken into account in clinical decision
making. Further investigation of current predictors and existing
scores as well as new studies involving larger patient
populations and more sophisticated statistical prediction
models are necessary. Additionally, a short description of
our empirical institutional approach to management of
RVF following LVAD implantation is provided

Ključne riječi

Hrčak ID:

139286

URI

https://hrcak.srce.hr/139286

Datum izdavanja:

15.12.2014.

Posjeta: 1.139 *