Right Ventricular Failure Following Left Ventricular Assist Device Implantation

• 作者: Amitabh Satsangi Niraghatam Harshavardhan
• 来源期刊: 心血管外科国际期刊(英文)
• 学科: 医学
• 关键词: Left Ventricular Assist Device (LVAD) Right Ventricular Failure (RVF) Right Ventricular Assist Device (RVAD) Right Ventricular Stroke Work Index (RVSWI) Tricuspid Regurgitation (TR)
• 年，卷（期）: xxgwkgjqkyw_2020,（12）
• 页码范围: 243-253
• 页数: 11页
• 分类号: R54

摘要

Left ventricular assist device (LVAD) is being used increasingly in recent years for end stage heart failure as a bridge to transplant (BTT) and also as a destination therapy (DT). Patients with end stage heart failure have some degree of elevated pulmonary capillary wedge pressure, causing right ventricular hypertrophy which in due course leads to decreased dilatation of the RV and fall in cardiac output & severe tricuspid regurgitation (TR) presenting with features of RV failure (RVF). Implantation of LVAD improves left heart function at the cost of right ventricular output with an incidence of 25%-30%. RVF may lead to impaired LVAD flow, difficulty in weaning from cardio-pulmonary bypass (CPB), decreased tissue perfusion and multi-organ failure. In this article we comprehended the pathophysiology leading to RVF post LVAD implantation and its preoperative predictors and the various treatment modalities for managing RVF post LVAD implantation.