Right Ventricular Failure After Left Ventricular Assist Device Placement—The Beginning of the End or Just Another Challenge?

Turner, Katja

doi:10.1053/j.jvca.2018.07.047

Cited by 38 publications

(26 citation statements)

References 85 publications

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“…To estimate potential candidates' risk of developing RVF post LVAD implantation, a large number of studies have attempted to identify clinical predictors and develop risk models. These predictors and risk models are summarized in two recent review articles and a meta-analysis (Bellavia et al 2017;Lampert and Teuteberg 2015;Turner 2019). However, the clinical application of these risk models has been limited for several reasons.…”

Section: Right Ventricular Functionmentioning

confidence: 99%

Ventricular Assist Device as Bridge-to-Transplant

Nguyen¹,

Li²

2020

Organ and Tissue Transplantation

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Due to the limited donor supply and long wait times for heart transplantation, the use of a ventricular assist device as a bridge to heart transplantation is increasing. With the development of the continuous flow device, there has been improved mechanical durability with a resultant decrease in waitlist mortality for patient who are waiting for heart transplantation. When selecting patients for potential assist device therapy, it is important to consider heart failure severity for timing of device implantation, right ventricular function, and ability to tolerate anticoagulation.

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Section: Right Ventricular Functionmentioning

confidence: 99%

Ventricular Assist Device as Bridge-to-Transplant

Nguyen¹,

Li²

2020

Organ and Tissue Transplantation

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“…It can be treated with diuretics and modification of LVAD parameters. In severe cases, mechanical support of the right ventricle may be required with a biventricular assist device [37,38].…”

Section: Right Hfmentioning

confidence: 99%

Ventricular Assist Devices Insertion, Overview and Anesthetic Considerations

Mageed¹

2020

ASOAJ

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Ventricular assist devices (VAD) represent a revolution for the management of severe heart failure. Their insertion requires the use of cardiopulmonary bypass. They are used either permanently for long term treatment of refractory heart failure or temporally as a bridge until cardiac transplantation and until cardiac recovery from reversible cardiomyopathy. Insertion of VAD is a risky surgery with high incidence of complication such as bleeding, cardiac tamponade, renal failure and device failure. Anesthetic management of patients with heart failure undergoing VAD insertion requires full review of the patient critical condition, understanding VAD physiology, extensive hemodynamic monitoring and a harmony between cardiac anesthesia and surgical teams. Marinating and protection the right ventricular function is highly important for the continuation of VAD function. The aim of this review is to put new insights on anesthetic management of VAD insertion and to show their different types and their physiology.

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“…The function of an LVAD is to provide systemic blood circulatory support to augment the failing LV and restore normal cardiac output, however, this is greatly dependent on the appropriate filling of the LV by the RV. Following implantation, initiation of LVAD support begins by slowly increasing pump speed, which decompresses the LV and increases preload to the RV [97]. This exposes the RV to loading conditions similar to those provided by a normal functioning LV, leading to an increase in RV preload; an alteration of RV contractility, and an increase in RV afterload due to pulmonary vasoconstriction, all of which can lead to RVF with any existing RV impairment [96].…”

Section: Mechanical Circulatory Support (Mcs)mentioning

confidence: 99%

Hurdles to Cardioprotection in the Critically Ill

Hoe

Bartnikowski

Wells

et al. 2019

IJMS

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Cardiovascular disease is the largest contributor to worldwide mortality, and the deleterious impact of heart failure (HF) is projected to grow exponentially in the future. As heart transplantation (HTx) is the only effective treatment for end-stage HF, development of mechanical circulatory support (MCS) technology has unveiled additional therapeutic options for refractory cardiac disease. Unfortunately, despite both MCS and HTx being quintessential treatments for significant cardiac impairment, associated morbidity and mortality remain high. MCS technology continues to evolve, but is associated with numerous disturbances to cardiac function (e.g., oxidative damage, arrhythmias). Following MCS intervention, HTx is frequently the destination option for survival of critically ill cardiac patients. While effective, donor hearts are scarce, thus limiting HTx to few qualifying patients, and HTx remains correlated with substantial post-HTx complications. While MCS and HTx are vital to survival of critically ill cardiac patients, cardioprotective strategies to improve outcomes from these treatments are highly desirable. Accordingly, this review summarizes the current status of MCS and HTx in the clinic, and the associated cardiac complications inherent to these treatments. Furthermore, we detail current research being undertaken to improve cardiac outcomes following MCS/HTx, and important considerations for reducing the significant morbidity and mortality associated with these necessary treatment strategies.

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Right Ventricular Failure After Left Ventricular Assist Device Placement—The Beginning of the End or Just Another Challenge?

Cited by 38 publications

References 85 publications

Ventricular Assist Device as Bridge-to-Transplant

Ventricular Assist Device as Bridge-to-Transplant

Ventricular Assist Devices Insertion, Overview and Anesthetic Considerations

Hurdles to Cardioprotection in the Critically Ill

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