Featured mechanical circulatory support articleRight heart failure and “failure to thrive” after left ventricular assist device: Clinical predictors and outcomes
Section snippets
Methods
This study was approved by the Human Research Ethics Committee at St. Vincent's Hospital, Sydney.
Demographics
For the overall group, the average age at implant was 51.2 ± 16.6 years (range, 14–75 years), and mean LVAD support time was 385 ± 283 days (range, 21–1,011 days). Before LVAD implant, 22 patients were at Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 1, 17 were at level 2, and 1 was at level 3. At the time of LVAD implantation, 20 (50%) were receiving pre-operative support from an intra-aortic balloon pump, and 4 (10%) were receiving venoarterial ECMO.
Discussion
Excellent overall survival and outcomes were documented in this cohort of consecutive patients with centrifugal continuous-flow LVADs. However, not all patients who undergo LVAD implantation progress smoothly, due to early RHF and FTT, despite hemodynamic improvements. Pre-operative TR severity was the best predictor of early post-implant RHF in this study, but early RHF did not necessarily impair long-term outcomes. Long-term clinical outcomes were predicted mainly by patient age and were
Disclosure statement
P. Spratt owns stock in HeartWare Inc, but none of the other authors have a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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