A Useful Scoring System For Predicting Right Ventricular Assist Device Requirement Among Patients with a Paracorporeal Left Ventricular Assist Device.
Daisuke Nitta,Koichiro Kinugawa,Teruhiko Imamura,Eisuke Amiya,Masaru Hatano,Osamu Kinoshita,Kan Nawata,Minoru Ono,Issei Komuro +8 more
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TL;DR: RVAD requirement is associated with poor long-term survival, and this simple scoring system using PVR and mean RAP/mean PAWP may be useful for predicting RVAD requirement in such patients.
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Abstract: Ventricular assist devices (VADs) have become an important therapy for advanced heart failure, however, the prognosis of those who receive a biventricular assist device (BiVAD) is still poor. We enrolled 70 patients who underwent paracorporeal VAD (Nipro-VAD®) implantation between 2004 and 2015 and studied the preoperative risk factors, including hemodynamic parameters for RVAD requirement. Furthermore, 2-year survival was compared between the BiVAD group and LVAD only group. Fourteen patients (20%) required RVAD. The BiVAD group had a significantly smaller left ventricular diastolic/systolic dimension, lower mean pulmonary artery wedge pressure (PAWP), lower cardiac index (CI), higher pulmonary vascular resistance (PVR), higher mean right atrial pressure (RAP), lower pulmonary artery pulsatility index (PAPi), lower right ventricular stroke work index (RVSWI), and higher mean RAP/mean PAWP ratio preoperatively. After multivariate analysis, only PVR > 4.5 Wood units: WU (P = 0.013, odds ratio: OR 7.9) and mean RAP/mean PAWP > 0.8 (P 4.5 WU and 2 points to mean RAP/mean PAWP > 0.8. This simple scoring method adequately stratified the incidence of RVAD implantation (score 0: 4.4%, score 1: 28.6%, score 2: 41.7%, score 3: 83.3%). The cumulative survival rate at 2-year after VAD implantation was significantly worse among patients who required RVAD support compared to the LVAD only group (28.5% versus 74.4%, P = 0.009). RVAD requirement is associated with poor long-term survival, and this simple scoring system using PVR and mean RAP/mean PAWP may be useful for predicting RVAD requirement in such patients.
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Citations
Pulmonary artery pulsatility index as a predictor of right ventricular failure in left ventricular assist device recipients: A systematic review
TL;DR: In this paper , the predictive value of pre-operative Pulmonary artery pulsatility index (PAPi) to right ventricular failure (RVF) in the setting of LVAD implantation was analyzed.
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Sildenafil Reduces the Risk of Thromboembolic Events in HeartMate II Patients with Low-Level Hemolysis and Significantly Improves the Pulmonary Circulation.
Rashad Zayat,Usaama Ahmad,Christian Stoppe,Mohammad Amen Khattab,Fateh Arab,Ajay Moza,L. Tewarie,Andreas Goetzenich,Rüdiger Autschbach,Heike Schnoering +9 more
TL;DR: Sildenafil treatment among HMII patients with LLH reduced the risk of thromboembolic events and significantly improved and decompressed the pulmonary circulation during HMII support.
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Longitudinal Trajectories of Hemodynamics Following Left Ventricular Assist Device Implantation.
T. Fujino,Aline Sayer,D. Nitta,Teruhiko Imamura,Nikhil Narang,Ann Nguyen,Daniel Rodgers,Jayant Raikhelkar,Bryan Smith,Gene Kim,C. LaBuhn,Valluvan Jeevanandam,Daniel Burkhoff,Gabriel Sayer,Nir Uriel,Nir Uriel +15 more
TL;DR: Despite improvement in left-side filling pressures and cardiac index following LVAD implantation, RAP increased and PAPI decreased over time suggesting progressive right ventricular dysfunction.
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Mechanical circulatory support for the right ventricle in combination with a left ventricular assist device.
TL;DR: This review describes an overview of RHF post-LVAD implant including natural history, prevalence, pathophysiology, outcomes, and challenges to predict R HF post- LVAD implant and focuses on right ventricular assist devices (RVADs) and their clinical outcomes.
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A systematic review and physiology of pulmonary artery pulsatility index in left ventricular assist device therapy
Ivan Yim,Ayisha M. Khan-Kheil,Nigel E Drury,Hoong Sern Lim +3 more
- 01 May 2023
TL;DR: In this paper , the authors conducted a systematic review to assess the relationship between Pulmonary artery pulsatility index (PAPi) and RHF and death in patients undergoing LVAD implantation.
References
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Clyde W. Yancy,Mariell Jessup,Biykem Bozkurt,Javed Butler,Donald E. Casey,Mark H. Drazner,Gregg C. Fonarow,Stephen A. Geraci,Tamara B. Horwich,James L. Januzzi,Maryl R. Johnson,Edward K. Kasper,Wayne C. Levy,Frederick A. Masoudi,Patrick E. McBride,John J.V. McMurray,Judith E. Mitchell,Pamela N. Peterson,Barbara Riegel,Flora Sam,Lynne W. Stevenson,W.H. Wilson Tang,Emily J. Tsai,Bruce L. Wilkoff +23 more
TL;DR: In this article, Anderson et al. proposed a new FAHA Chair, Jeffrey L. Anderson, MD, FACC, FAHA, Chair-Elect, Alice K. Jacobs et al., this article and Biykem Bozkurt.
12.4K
Long-Term Use of a Left Ventricular Assist Device for End-Stage Heart Failure
Eric A. Rose,Annetine C. Gelijns,Alan J. Moskowitz,Daniel F. Heitjan,L.W. Stevenson,W Dembitsky,J W Long,D D Ascheim,Anita R. Tierney,R G Levitan,John T. Watson,P Meier,Nuala S. Ronan,P A Shapiro,Ronald M. Lazar,Leslie W. Miller,L Gupta,O.H. Frazier,Patrice Desvigne-Nickens,Mehmet C. Oz,V L Poirier +20 more
TL;DR: The use of a left ventricular assist device in patients with advanced heart failure resulted in a clinically meaningful survival benefit and an improved quality of life.
3.8K
Seventh INTERMACS annual report: 15,000 patients and counting
James K. Kirklin,David C. Naftel,Francis D. Pagani,Robert L. Kormos,Lynne W. Stevenson,Elizabeth D. Blume,Susan L. Myers,Marissa A. Miller,J. Timothy Baldwin,James B. Young +9 more
TL;DR: The seventh annual report of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) summarizes the first 9 years of patient enrollment and a detailed analysis of outcomes after mechanical circulatory support for ambulatory heart failure is presented.
1.3K
Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: Incidence, risk factors, and effect on outcomes
Robert L. Kormos,Jeffrey J. Teuteberg,Francis D. Pagani,Stuart D. Russell,Ranjit John,Leslie W. Miller,Todd Massey,Carmelo A. Milano,Nader Moazami,Kartik S. Sundareswaran,David J. Farrar +10 more
TL;DR: The incidence of right ventricular failure in patients with a HeartMate II ventricular assist device is comparable or less than that of patients with pulsatile-flow devices and might benefit from preoperative optimization of right heart function or planned biventricular support.
908
The right ventricular failure risk score a pre-operative tool for assessing the risk of right ventricular failure in left ventricular assist device candidates.
TL;DR: The RVFRS, composed of routinely collected, noninvasive pre-operative clinical data, effectively stratifies the risk of RV failure and death after LVAD implantation.
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