Predictors of right ventricular failure after implantation of left ventricular assist devices

Predictors of right ventricular failure after implantation of left ventricular assist devices Right ventricular failure, Mechanical circulatory support, Ventricular assist device, Risk factors Congratulations to Boegershausen et al. [1] on their study. As the authors have noted, the incidence of right ventricular failure (RVF) development after implantation of left ventricular assist devices (LVADs), which is the most important treatment option for advanced stage heart failure, is not very low. In various series, this ratio is up to 50% [2–4]. As can be seen, RVF development rates are extremely high. Even more important subject is the increased mortality rates when RVF develops after LVAD. Therefore, determining the RVF predictors after LVAD is frequently discussed as an important topic today. But, in the literature, many different parameters have been emphasized with regard to the predictive factors for the development of RVF after LVAD. For example, in this study, Boegershausen et al. report that only the basal longitudinal systolic strain of the right ventricular (RV) free wall (PSLSbasal) and the central venous pressure are predictive factors for RVF. Similarly, another study of 4428 patients reported that high central venous pressure and low right ventricular stroke work index were predictive factors for RVF after LVAD [4]. But, in the same study, unlike the study by Boegershausen et al., they reported that international normalized ratio, N-terminal pro-b-type natriuretic peptide, moderate-to-severe right ventricular dysfunction, increased right ventricular/left ventricular ratio and preprocedural ventilator dependence were also predictive factors for RVF after LVAD implantation. Another study [5] reported that parameters such as increased pulmonary artery pressure, increased right atrial pressure, decreased stroke volume, preoperative severe tricuspid regurgitation and renal replacement therapy were risk factors for RFV, unlike the study by Boegershausen et al. It is, of course, it is possible to increase these examples. However, it is clear that there is no single predictive factor for the development of RVF after LVAD. Another issue that we want to mention is that the main treatments applied by Boegershausen et al. for RVF after LVAD implantation are vasodilator inhalation, prolongation of inotropic treatment and right-sided extracorporeal membrane oxygenation. However, other ventricular support systems, such as a Levitronix CentriMag ventricular assist device for the right side, have never been used. How do authors explain the reason for this? We believe that sharing the authors’ ideas on this subject will add value to their study. REFERENCES [1] Boegershausen N , Zayat R , Aljalloud A , Musetti G , Goetzenich A , Tewarie L et al. Risk factors for the development of right ventricular failure after left ventricular assist device implantation-a single-centre retrospective with focus on deformation imaging . Eur J Cardiothorac Surg 2017 ; 52 : 1069 – 76 . Google Scholar CrossRef Search ADS PubMed [2] McIlvennan CK , Magid KH , Ambardekar AV , Thompson JS , Matlock DD , Allen LA. Clinical outcomes after continuous-flow left ventricular assist device: a systematic review . Circ Heart Fail 2014 ; 7 : 1003 – 13 . Google Scholar CrossRef Search ADS PubMed [3] Lampert BC , Teuteberg JJ. Right ventricular failure after left ventricular assist devices . J Heart Lung Transplant 2015 ; 34 : 1123 – 30 . Google Scholar CrossRef Search ADS PubMed [4] Bellavia D , Iacovoni A , Scardulla C , Moja L , Pilato M , Kushwaha SS et al. Prediction of right ventricular failure after ventricular assist device implant: systematic review and meta-analysis of observational studies . Eur J Heart Fail 2017 ; 19 : 926 – 46 . Google Scholar CrossRef Search ADS PubMed [5] Kiernan MS , Grandin EW , Brinkley M Jr , Kapur NK , Pham DT , Ruthazer R et al. Early right ventricular assist device use in patients undergoing continuous-flow left ventricular assist device implantation: incidence and risk factors from the interagency registry for mechanically assisted circulatory support . Circ Heart Fail 2017 ; 10 : e003863 . Google Scholar CrossRef Search ADS PubMed © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

Predictors of right ventricular failure after implantation of left ventricular assist devices

Loading next page...
 
/lp/ou_press/predictors-of-right-ventricular-failure-after-implantation-of-left-A0yVHo0b5v
Publisher
Oxford University Press
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
ISSN
1010-7940
eISSN
1873-734X
D.O.I.
10.1093/ejcts/ezy012
Publisher site
See Article on Publisher Site

Abstract

Right ventricular failure, Mechanical circulatory support, Ventricular assist device, Risk factors Congratulations to Boegershausen et al. [1] on their study. As the authors have noted, the incidence of right ventricular failure (RVF) development after implantation of left ventricular assist devices (LVADs), which is the most important treatment option for advanced stage heart failure, is not very low. In various series, this ratio is up to 50% [2–4]. As can be seen, RVF development rates are extremely high. Even more important subject is the increased mortality rates when RVF develops after LVAD. Therefore, determining the RVF predictors after LVAD is frequently discussed as an important topic today. But, in the literature, many different parameters have been emphasized with regard to the predictive factors for the development of RVF after LVAD. For example, in this study, Boegershausen et al. report that only the basal longitudinal systolic strain of the right ventricular (RV) free wall (PSLSbasal) and the central venous pressure are predictive factors for RVF. Similarly, another study of 4428 patients reported that high central venous pressure and low right ventricular stroke work index were predictive factors for RVF after LVAD [4]. But, in the same study, unlike the study by Boegershausen et al., they reported that international normalized ratio, N-terminal pro-b-type natriuretic peptide, moderate-to-severe right ventricular dysfunction, increased right ventricular/left ventricular ratio and preprocedural ventilator dependence were also predictive factors for RVF after LVAD implantation. Another study [5] reported that parameters such as increased pulmonary artery pressure, increased right atrial pressure, decreased stroke volume, preoperative severe tricuspid regurgitation and renal replacement therapy were risk factors for RFV, unlike the study by Boegershausen et al. It is, of course, it is possible to increase these examples. However, it is clear that there is no single predictive factor for the development of RVF after LVAD. Another issue that we want to mention is that the main treatments applied by Boegershausen et al. for RVF after LVAD implantation are vasodilator inhalation, prolongation of inotropic treatment and right-sided extracorporeal membrane oxygenation. However, other ventricular support systems, such as a Levitronix CentriMag ventricular assist device for the right side, have never been used. How do authors explain the reason for this? We believe that sharing the authors’ ideas on this subject will add value to their study. REFERENCES [1] Boegershausen N , Zayat R , Aljalloud A , Musetti G , Goetzenich A , Tewarie L et al. Risk factors for the development of right ventricular failure after left ventricular assist device implantation-a single-centre retrospective with focus on deformation imaging . Eur J Cardiothorac Surg 2017 ; 52 : 1069 – 76 . Google Scholar CrossRef Search ADS PubMed [2] McIlvennan CK , Magid KH , Ambardekar AV , Thompson JS , Matlock DD , Allen LA. Clinical outcomes after continuous-flow left ventricular assist device: a systematic review . Circ Heart Fail 2014 ; 7 : 1003 – 13 . Google Scholar CrossRef Search ADS PubMed [3] Lampert BC , Teuteberg JJ. Right ventricular failure after left ventricular assist devices . J Heart Lung Transplant 2015 ; 34 : 1123 – 30 . Google Scholar CrossRef Search ADS PubMed [4] Bellavia D , Iacovoni A , Scardulla C , Moja L , Pilato M , Kushwaha SS et al. Prediction of right ventricular failure after ventricular assist device implant: systematic review and meta-analysis of observational studies . Eur J Heart Fail 2017 ; 19 : 926 – 46 . Google Scholar CrossRef Search ADS PubMed [5] Kiernan MS , Grandin EW , Brinkley M Jr , Kapur NK , Pham DT , Ruthazer R et al. Early right ventricular assist device use in patients undergoing continuous-flow left ventricular assist device implantation: incidence and risk factors from the interagency registry for mechanically assisted circulatory support . Circ Heart Fail 2017 ; 10 : e003863 . Google Scholar CrossRef Search ADS PubMed © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

Journal

European Journal of Cardio-Thoracic SurgeryOxford University Press

Published: Feb 6, 2018

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off