Preoperative and postoperative comparison of patients with univentricular and biventricular support with the thoratec ventricular assist device as a bridge to cardiac transplantation

Farrar, David J.; Hill, J. Donald; Pennington, D. Glenn; McBride, Lawrence R.; Holman, William L.; Kormos, Robert L.; Esmore, Donald; Gray, Laman A.; Seifert, Paul; Schoettle, G.Phillip; Moore, Christopher A.; Hendry, Paul; Bhayana, Joginder N.

doi:10.1016/s0022-5223(97)70416-1

Cited by 196 publications

(125 citation statements)

References 12 publications

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“…Previous studies including our study showed that RVAD requirement was a significant predictor of overall mortality and device-related infections. 14,18, 19 In more recent studies, it was reported that laboratory variables, which are indirectly related to RV function (eg, bilirubin and Cr levels), were more strongly associated with the need for biventricular support than with the preoperative hemodynamic variables. 19,20 Therefore, early LVAD implantation before a progressive decline of end-organ function is essential to prevent these postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Predictor of Early Mortality for Severe Heart Failure Patients With Left Ventricular Assist Device Implantation

Yoshioka

Sakaguchi

Saito

et al. 2012

Circ J

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Section: Discussionmentioning

confidence: 99%

Predictor of Early Mortality for Severe Heart Failure Patients With Left Ventricular Assist Device Implantation

Yoshioka

Sakaguchi

Saito

et al. 2012

Circ J

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“…The use of uni-or biventricular assistance is the key to therapeutic success in treating patients with heart failure [10,11]. However, it is difficult to predict who patients are at increased risk of developing RV failure, because there is no consensus on criteria for preoperative risk among these studies [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Cavo-pulmonary anastomosis associated with left ventricular in comparison with biventricular circulatory support in acute heart failure

Santos¹,

Benício²,

Júnior³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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“…1,9-15 Thus, previous important studies on this topic showed that patients with severe RV failure after LVAD implantation usually have a lower preoperative CI, more elevated CVP, lower tricuspid annulus peak systolic excursion, higher bilirubin, higher aspartate and alanine aminotransferase, higher blood urea nitrogen, and higher serum creatinine levels. 1,3,[14][15][16][17][18][19] However, not all of these variables appeared in all studies as relevant risk factors that might be at least partially explained by differences between different centers with regard to their selection criteria for LVAD and BVAD implantation. Some investigating groups did not find, for example, elevated serum bilirubin levels to be a relevant risk factor for postoperative RV failure in their patients.…”

mentioning

confidence: 99%

Load Dependency of Right Ventricular Performance Is a Major Factor to be Considered in Decision Making Before Ventricular Assist Device Implantation

et al. 2013

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Background-Left ventricular assist devices (LVADs) provide better outcome than biventricular devices, but it is a challenge to predict the impact of LV mechanical unloading on postoperative right ventricular (RV) function preoperatively. We assessed the load dependency in RV performance before and after LVAD implantation aiming to improve preoperative decision making. Methods and Results-Laboratory, echocardiography, and right heart catheterization data collected from 205 patients before LVAD implantation were tested for relationship with postoperative RV function. Comparing patients with different time-course of RV function after LVAD implantation, we found significant differences (P<0.01) in preoperative RV enddiastolic short-/long-axis and long-axis/length-area ratios, tricuspid annulus peak systolic velocity, RV peak longitudinal global systolic strain rate, systolic pressure gradient between RV and right atrium (ΔP RV−RA ), tricuspid regurgitation velocity-time integral, and pulmonary arterial pressure between patients with and without postoperative RV failure. High predictive values for postoperative RV failure were found for end-diastolic short-/long-axis ratio ≥0.6, tricuspid annulus peak systolic velocity <8 cm/s, and peak systolic longitudinal strain rate <0.6/s in patients with maximum ΔP RV−RA <35 mm Hg. These parameters also seemed predictive for RV failure in patients with tricuspid regurgitation grade >2 and pulmonary arterial pressure <50 mm Hg. End-diastolic short-/long-axis ratio <0.6, tricuspid annulus peak systolic velocity ≥8 cm/s, and peak systolic longitudinal strain rate ≥0.6 in patients with maximum ΔP RV−RA ≥35 mm Hg showed high predictive values for postoperative freedom from RV failure. The RV load adaptation index seemed particularly predictive for RV function after LVAD implantation. Conclusions-RV geometry and velocity of contraction before LVAD implantation become more predictive for postoperative RV function and can improve decision making before VAD implantation if preoperative RV pressure load and tricuspid regurgitation are also considered. (Circulation. 2013;128[suppl 1]:S14-S23.)Key Words: echocardiography ◼ heart failure ◼ heart-assist device ◼ hemodynamics ◼ risk factors ◼ surgery ◼ ventricles © 2013 American Heart Association, Inc.Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIRCULATIONAHA.112.000335From the Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany (M.D., E.P., T.K., A.S., A.L., J.V., C.K., R.H.); and German Centre for Cardiovascular Research (DZHK), partner site Berlin, Germany (R.H.).Presented at the 2012 American Heart Association meeting in Los Angeles, CA, November 3-7, 2012 Dandel et alDecision Before Ventricular Assist Device Implantation S15 reduction of pulmonary vascular resistance (PVR) subsequent to LVAD implantation, as long as the postoperative outcome is not impaired by irreversibly poor end-organ function, and LV unloading is properly optimized to avoid excessive interventricu...

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Preoperative and postoperative comparison of patients with univentricular and biventricular support with the thoratec ventricular assist device as a bridge to cardiac transplantation

Abstract: Patients who received LVADs were less severely ill before the operation and consequently were more likely to survive after the operation. As the severity of illness increases, patients are more likely to require biventricular support.

Cited by 196 publications

References 12 publications

Predictor of Early Mortality for Severe Heart Failure Patients With Left Ventricular Assist Device Implantation

Predictor of Early Mortality for Severe Heart Failure Patients With Left Ventricular Assist Device Implantation

Cavo-pulmonary anastomosis associated with left ventricular in comparison with biventricular circulatory support in acute heart failure

Load Dependency of Right Ventricular Performance Is a Major Factor to be Considered in Decision Making Before Ventricular Assist Device Implantation

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