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Abstracts: ASAIO Cardiac Abstracts

PREDICTION OF RIGHT VENTRICULAR DYSFUNCTION AFTER IMPLANTATION OF LEFT VENTRICULAR ASSIST DEVICES

Potapov, Evgenij V1; Weng, Yuguo1; Pasic, Miralem1; Jurmann, Michael1; Stein, Julia1; Hennig, Felix1; Lehmkuhl, Hans1; Hetzer, Roland1

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Background

Right ventricular failure (RVF) after LVAD implantation is a serious complication. However, its prediction before surgery remains difficult We evaluated preoperative parameters as possible predictors of RVF after LVAD implantation.

Methods

Between January 2002 and December 2004 LVADs were implanted in 111 patients with chronic end-stage heart failure. Patients requiring an LVAD for postcardiotomy heart failure were excluded. The patients were divided into two groups: group I (n=102) with normal RV function after LVAD implantation and group II (n=9) with RVF. Preoperative echocardiographic findings (RV diameter, ejection fraction) and laboratory and hemodynamic parameters were analyzed. Patients were defined as having RVF if two or more of the following criteria were met during the first 24 hours after LVAD implantation: MAP <55 mmHg, CVP >16 mmHg, SvO2 <55%, CI 2, inotropic support >20 units. In addition, 30-day survival was compared.

Results

The parameters showed no differences between groups. Overall 30-day survival rate was 80%. Patients who survived for >30 days had preoperatively less inotropic support (p=0.007), lower WBC (10.4±3.9 vs. 14.7±4.5, p<0.001) and lower serum creatinine (1.4±1.03 vs. 2±1.17, p<0.038) only.

Conclusion

Signs of inflammation and poor renal function predict 30-day mortality but preoperative prediction of RVF after LVAD implantation using routine parameters is not possible. New approaches to predicting RVF after LVAD implantation should be evaluated in future studies.

Copyright © 2005 by the American Society for Artificial Internal Organs