Load Dependency of Right Ventricular Performance Is a Major Factor to be Considered in Decision Making Before Ventricular Assist Device Implantation

BACKGROUND—Left ventricular assist devices (LVADs) provide better outcome than biventricular devices, but it is a challenge to predict the impact of LV mechanical unloading on postoperative right ventricular (RV) function preoperatively. We assessed the load dependency in RV performance before and a...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2013-09, Vol.128 (26_suppl_1 Suppl 1), p.S14-S23
Main Authors: Dandel, Michael, Potapov, Evgenij, Krabatsch, Thomas, Stepanenko, Alexander, Löw, Alexandra, Vierecke, Juliane, Knosalla, Christoph, Hetzer, Roland
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular system
Decision Making
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Female
Heart
Heart Failure - diagnostic imaging
Heart Failure - physiopathology
Heart Failure - surgery
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart-Assist Devices
Humans
Intensive care medicine
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Prospective Studies
Retrospective Studies
Ultrasonic investigative techniques
Ultrasonography
Ventricular Function, Right - physiology
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Summary:BACKGROUND—Left ventricular assist devices (LVADs) provide better outcome than biventricular devices, but it is a challenge to predict the impact of LV mechanical unloading on postoperative right ventricular (RV) function preoperatively. We assessed the load dependency in RV performance before and after LVAD implantation aiming to improve preoperative decision making. METHODS AND RESULTS—Laboratory, echocardiography, and right heart catheterization data collected from 205 patients before LVAD implantation were tested for relationship with postoperative RV function. Comparing patients with different time-course of RV function after LVAD implantation, we found significant differences (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.112.000335