External Validation and Comparison of the EUROMACS and Right Ventricular Failure Risk Score for Right Ventricular Failure Prediction after Left Ventricular Assist Device

Purpose To date, most scores derived to predict early RVF after LVAD implantation lack external validation. The aim of our study was to validate and compare the EUROMACS risk score and the right ventricular failure risk score (RVFRS). Methods From 1/2007 to 12/2017, 268 continuous-flow LVADs were implanted at Montefiore's Medical Center. We calculated both the EUROMACS score and the RVFRS and their predictive performance for early RVF defined as need for short- or long-term right-sided circulatory support, continuous inotropic support for ≥14 days, or nitric oxide ventilation for ≥48 hours post-operatively. Results RVF occurred in 100 patients (37%). Demographic characteristics were similar among patients, but RVF patients had higher baseline levels of AST and bilirubin, higher right atrial pressure, lower PAPi and more echocardiographic RV dysfunction (p Conclusion In an external validation cohort, both the EUROMACS and RVFRS can predict RVF after LVAD. However, the clinical utility of these scores is limited.