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Right heart failure after left ventricular assist device implantation: a persistent problem

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Abstract

Left ventricular assist device (LVAD) is an option for bridge-to-transplant or destination therapy for patients with end-stage heart failure. Right heart failure (RHF) remains a complication after LVAD implantation that portends high morbidity and mortality, despite advances in LVAD technology. Definitions of RHF vary, but generally include the need for inotropic or pulmonary vasodilator support, or potential right ventricular (RV) mechanical circulatory support. This review covers the complex pathophysiology of RHF related to underlying myocardial dysfunction, interventricular dependence, and RV afterload, as well as treatment strategies to curtail this challenging problem.

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  1. Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 207, Minneapolis, MN, 55455, USA

    Chesney Siems, Rishav Aggarwal, Andrew Shaffer & Ranjit John

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AS received research grants from Cryolife and Abbott. RJ is a consultant for Abbott and Medtronic and received research grants from Abbott.

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Siems, C., Aggarwal, R., Shaffer, A. et al. Right heart failure after left ventricular assist device implantation: a persistent problem. Indian J Thorac Cardiovasc Surg 39 (Suppl 1), 161–169 (2023). https://doi.org/10.1007/s12055-023-01481-z

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