Predictive factors of right ventricular failure after left ventricular assist device implantation

Objective Study and assess the existence of predictive risk factors for right ventricular failure (RVF) after left ventricular assist device implantation (LVAD) Methods Clinical, hemodynamic, and echocardiographic data were collected on 64 patients undergoing LVAD implantation. RVF was defined as the need for placement of an RV assist device, or the use of inotropic agents for 14 days. Results RV failure occurred in 37 of 64 patients (58%) and 21 patients died from RVF. Patients who suffer from RVF had significantly lower INTERMACS profiles: 31 patients with RV failure (83.8%) were INTERMACS 1, 2 or 3 versus 8 patients (29.6%) without RV failure (P = 0.0003). There was no significant difference considering echocardiographic parameters as pre-operative right ventricular assessment between the two groups (visual appreciation, TAPSE, doppler lateral systolic velocity, tricuspid insufficiency). Conclusion RVF is related to the severity of the patients before surgery and more specifically to low INTERMACS profiles (1,2 or 3). However, in our study echocardiographic parameters used for pre-operative right ventricular assessment are not associated with RVF occurrence.