Impact of Right Heart Failure on Clinical Outcome of Left Ventricular Assist Devices (LVAD) Implantation: Single Center Experience

被引:3
作者
Terzic, Dusko [1 ,2 ]
Putnik, Svetozar [1 ,2 ]
Nestorovic, Emilija [1 ,2 ]
Jovicic, Vladimir [1 ,2 ]
Lazovic, Dejan [1 ,2 ]
Rancic, Nemanja [3 ,4 ]
Milicevic, Vladimir [1 ]
Ivanisevic, Dragan [1 ]
Karan, Radmila [1 ,2 ]
Mikic, Aleksandar [1 ,2 ]
机构
[1] Univ Clin Ctr Serbia, Dept Heart Transplant, Clin Cardiac Surg, LVAD & ECMO, Belgrade 11000, Serbia
[2] Univ Belgrade, Med Fac, Belgrade 11000, Serbia
[3] Univ Def, Fac Med, Mil Med Acad, Belgrade 11000, Serbia
[4] Mil Med Acad, Ctr Clin Pharmacol, Belgrade 11000, Serbia
关键词
left ventricular assist devices; end-stage heart failure; right ventricular failure; right heart failure; treatment; MECHANICAL CIRCULATORY SUPPORT; RISK SCORE; PREDICTORS; MANAGEMENT; THERAPY; SOCIETY;
D O I
10.3390/healthcare10010114
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The aim of this study was to examine the incidence and significance of right heart failure (RHF) in the early and late phase of left ventricular assist device (LVAD) implantation with the identification of predictive factors for the development of RHF. This was a prospective observational analytical cohort study. The study included 92 patients who underwent LVAD implantation and for whom all necessary clinical data from the follow-up period were available, as well as unambiguous conclusions by the heart team regarding pathologies, adverse events, and complications. Of the total number of patients, 43.5% died. The median overall survival of patients after LVAD implantation was 22 months. In the entire study population, survival rates were 88.04% at one month, 80.43% at six months, 70.65% at one year, and 61.96% at two years. Preoperative RHF was present in 24 patients, 12 of whom died and 12 survived LVAD implantation. Only two survivors developed early RHF (ERHF) and two late RHF (LRHF). The most significant predictors of ERHF development are brain natriuretic peptide (BNP), pre-surgery RHF, FAC < 20%, prior renal insufficiency, and total duration of ICU stay (HR: 1.002, 0.901, 0.858, 23.554, and 1.005, respectively). RHF following LVAD implantation is an unwanted complication with a negative impact on treatment outcome. The increased risk of fatal outcome in patients with ERHF and LRHF after LVAD implantation results in a need to identify patients at risk of RHF, in order to administer the available preventive and therapeutic methods.
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页数:16
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