Heart failure etiology and risk of right heart failure in adult left ventricular assist device support: the European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

Løgstrup, Brian Bridal; Němec, Petr; Schoenrath, Felix; Gummert, Jan; Pya, Yuriy; Potapov, Evgenij; Netuka, Ivan; Ramjankhan, Faiz; Parner, Erik Thorlund; By, T. de; Eiskjær, Hans

doi:10.1080/14017431.2020.1781239

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…After LVAD implantation development of right ventricular failure is one of the most feared complications. 29,30 Prediction of this clinical situation in LVAD patients is still an enigma. 28 Løgstrup et al 29 stated that patients with non-ischaemic heart failure revealed an increased incidence of postoperative right heart failure.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

et al. 2022

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Background: Despite recent advances in management of patients with advanced heart failure, mortality remains high. Aim of this study was to compare impact of different aetiology of ischaemic and idiopathic cardiomyopathy on early outcomes and long-term survival of patients after left ventricular assist device implantation. Methods: European Registry for Patients with Mechanical Circulatory Support (EUROMACS) gathers clinical data and follow-up parameters of LVAD recipients. Patients enrolled in the EUROMACS registry with primary diagnosis of either ischaemic ( n = 1190) or idiopathic ( n = 812) cardiomyopathy were included. Primary Endpoints were early mortality as well as long-term survival. Secondary endpoint were major postoperative adverse events, such as need for rethoracotomy. Additionally, a propensity-score matching analysis was performed for patients with ischaemic ( n = 509) and idiopathic ( n = 509) cardiomyopathy. Results: In terms of basic demographics and baseline parameters the two groups significantly differed as expected before propensity-score matching due to different aetiology of cardiomyopathy. Seven-day (52 (4.4%) versus 18 (2.2%); p = 0.009), 30-day (153 (12.9%) versus 73 (9.0%); p = 0.008) and in-hospital mortality (253 (19.7%) versus 123 (15.1%); p = 0.009) were significantly lower in the idiopathic cardiomyopathy group compared to the ischaemic cardiomyopathy group, whereas after propensity-score matching 30-day ( p = 0.169) was comparable and in-hospital mortality ( p = 0.051) was almost significant. Kaplan-Meier survival analysis revealed no significant difference in regard of long-term survival after propensity-score matching (Breslow-test p = 0.161 and LogRank-test p = 0.113). Conclusion: Though patients with ischaemic and idiopathic cardiomyopathy suffer from different cardiomyopathy aetiologies, 30-day-mortality and long-term survival of both groups were similar leading to the conclusion that covariates predominately influence mortality and survival of ischaemic and idiopathic cardiomyopathies.

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

et al. 2022

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“…RV failure is unfortunately rather common after LVAD implantation, occurring in up to 20-50% of cases. Patients with non-ischemic heart failure, such as our patient, have a significantly higher incidence than those with ischemic heart failure [1]. Several structural mechanisms can explain the etiology of RV dysfunction seen after LVAD implantation.…”

Section: Discussionmentioning

confidence: 73%

“…The postoperative care of these patients presents several challenges, with numerous complications that may potentially arise. One of the most serious is Right Ventricular (RV) failure, which occurs in 20-50% of LVAD patients, and leads to a longer hospital course and increased mortality [1]. There are several tools used to pre-dict post-implantation RV failure, but none are highly sensitive and all patients respond differently to LVAD insertion [2].…”

Section: Introductionmentioning

confidence: 99%

An unusual presentation of bradycardia, acidosis, and right ventricular dysfunction after left ventricular assist device implantation: A case report

Elia¹,

Katrivesis²,

Naqvi³

et al. 2021

J Clin Images Med Case Rep

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Right Ventricular (RV) dysfunction is a common complication seen in 20-50% of patients after Left-Ventricular Assist Device (LVAD) implantation. Although prediction models exist, it is challenging to prevent RV dysfunction and even more difficult to manage. Early recognition is crucial to determine the appropriate pharmacological therapies and decide if implementation of Mechanical Circulatory Support (MCS) is needed. Here, we present a case of RV dysfunction precipitated unexpectedly by a bradycardic episode. The RV dysfunction was refractory to traditional therapies but was successfully managed with right-sided MCS.

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“…RV failure is the most common complication post-LVAD implantation occurring in up to 70% of cases. 2 Several physiologic changes occur after LVAD placement that account for the increased risk of right heart failure. One pertains to the role of ventricular interdependence on ventricular septal motion change.…”

Section: Discussionmentioning

confidence: 99%

“Right” or Wrong Diagnosis? The Importance of Transesophageal Echocardiography to Assess the Etiology of Hypotension After Left Ventricular Assist Device Implantation

Katrivesis

Elia

Glovaci

et al. 2022

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Heart failure etiology and risk of right heart failure in adult left ventricular assist device support: the European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

Cited by 19 publications

References 25 publications

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

An unusual presentation of bradycardia, acidosis, and right ventricular dysfunction after left ventricular assist device implantation: A case report

“Right” or Wrong Diagnosis? The Importance of Transesophageal Echocardiography to Assess the Etiology of Hypotension After Left Ventricular Assist Device Implantation

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