MiscellaneousRisk Factors Predictive of Right Ventricular Failure After Left Ventricular Assist Device Implantation
Section snippets
Methods
The analysis was performed using a prospectively collected database from a large-volume, single center of 175 LVAD patients who underwent implantation from 1993 to 2008. The patients underwent implantation with the HeartMate XVE (n = 82, 47%), HeartMate VE (n = 42, 24%), HeartMate 1000 IP (n = 17, 10%), HeartMate II (n = 25, 14%; all devices manufactured by Thoratec, Pleasanton, California) or the Novacor device (n = 9, 5%; World Heart, Oakland, California). The LVADs were placed as BTT in 58%
Results
Of the 175 patients analyzed, 77 (44%) experienced RVF after LVAD implantation. Of the 77 patients who were diagnosed with RVF, 45 (58%) were treated medically with either inotropes or inhaled nitric oxide, and 32 (42%) required the placement of an RVAD after LVAD implantation. The survival rate between the non-RVF and RVF groups was 96% versus 80% at 30 days (p = 0.0012), 90% versus 70% at 180 days (p = 0.0011; Figure 1), and 83% versus 62% at 365 days (p = 0.002).
Table 1 displays the
Discussion
RVF in the early postoperative period after LVAD implantation remains a major cause of morbidity and mortality.5, 6, 7, 8, 9, 10, 11 In the present study, we demonstrated a substantial mortality rate associated with perioperative RVF in patients receiving an LVAD for end-stage heart failure. Furthermore, our results have clearly delineated the significant decrease in survival at 30, 180, and 365 days after LVAD implantation using our risk score model. The subgroup with a risk score of ≥12.5 had
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