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Fecal Transplant for Recurrent Clostridium difficile Colitis in CF-LVAD Supported Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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2
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Interventricular Septal Output While Supported on LVAD Therapy. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Pulsatile Pressure Delivery of Continuous Flow LVAD is Speed Dependent and Markedly Reduced Relative to Heart Failure Patients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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4
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Does Hemoglobin A1c Accurately Depict Diabetic Control in LVAD Patients? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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5
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Optimization Prior to Left Ventricular Assist Device Implantation is Associated with Reduced Risk of Severe Early Post-Implant Complications. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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6
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Decreased right ventricular strain before LVAD implantation is associated with adverse early outcome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
Right ventricular (RV) failure occurring after left ventricular assist device (LVAD) implantation is associated with increased mortality.
Purpose
We sought to determine whether RV strain by echocardiography predicts outcomes following LVAD.
Methods
Consecutive patients who underwent continuous flow LVAD placement at our clinic between February 2007 and October 2018 were included. Patients with complex congenital heart disease and arrhythmogenic right ventricular cardiomyopathy were excluded. Baseline characteristics, pre-operative hemodynamic catheterization (1 week) transthoracic echocardiography (1 month) measurements were obtained from the medical record. Speckle tracking RV free wall longitudinal 2D strain was measured using TomTec Imaging System. Univariate and multivariable analysis performed to identify predictors of mortality following LVAD.
Results
The study group was comprised of 323 patients (mean age 60.8±11.5, 79.9% male) of which 256 had adequate image quality for RV strain. RV strain was impaired in most patients (mean −11.7±3.47). RV strain of −8.1% was identified as predictive of poor outcomes. RV strain did not correlate with other measures of RV dysfunction including pulmonary artery pulsatility index (PAPi) and RVFAC. After adjusting for PAPi, RA pressure, and clinical cumulative risk scores (Matthews, Kormos and Lietz-Miller) impaired RV free wall longitudinal strain (OR: 1.14; 95% CI: 1.01–1.29, p=0.025), tricuspid regurgitation (by vena contracta width (TRvc) (OR: 1.19; 95% CI: 1.05–1.36, p=:0.0021) and smaller LVEDD (OR: 0.95; 95% CI: 0.92–0.99, p:0.023) predicted 30-day all-cause mortality and RV failure. Decreased RV free wall strain also predicted peri-operative mortality (22.58% vs. 4.89%, p=0.0003) and prolonged inotropic support (247.0.±277.4 vs. 122.8±139.3, p=0.024).
Conclusions
RV free wall strain is a non-invasive independent predictor of 30-day adverse outcomes (RV failure or all-cause mortality) Routine measurement of RV free strain may identify those patients at highest risk for early and long term mortality following LVAD.
Funding Acknowledgement
Type of funding source: None
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Functional Outcomes Not Significantly Impacted by Hemocompatibility-Related Adverse Event Burden among Different Devices. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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8
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Outcomes Following Discontinuation of Warfarin in Heartmate 3 Patients: A Multi-Center Review. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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9
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Hemocompatibility-Related Adverse Events: Is the Burden Different among Available Centrifugal Flow Pumps? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Exercise-Induced Hypoxemia Predicts Heart Failure Hospitalization and Death in Patients Supported with Left Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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11
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12
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Durability of Aortic Valve Repair with Park Stitch in Patients with Continuous Flow LVADS. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Incidence and Risk Factors of Late Bleeding in Patients Enrolled in the PREVENT Study. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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14
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Trends in Serum Lactate Dehydrogenase During HeartMate II Left Ventricular Assist Device Support and Its Relation to Clinical Outcomes: Insights from the PREVENT Study. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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The Effect of Infections in VAD Recipients on Survival and Risk of Thromboembolism. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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A Survey of Non-Heart Failure Cardiologists’ Perception and Understanding of Left Ventricular Assist Device Therapy and Outcomes. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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17
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Clinical and Microbiologic Characteristics of Infections in Left Ventricular Assist Device Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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18
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The Effect of Pre-Existing Hypercoagulable Disorders on Outcomes in Patients with LVADs. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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19
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Impact of Patient Distance from VAD Implanting Center on Outcomes. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management (PREVENT). J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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21
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A 7 Center Review of Left Ventricular Assist Device (LVAD) Caregiver Perceptions. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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22
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Bleeding Complications after Left Ventricular Assist Device Implantation: Association of Events and Impact on Survival. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Does Indication for Destination Therapy Affect Left Ventricular Assist Device Outcomes? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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24
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Can a Minimally Invasive OFF-pump Implantation Strategy be Considered Safe for Selected Patients Undergoing HeartWare Ventricular Assist Device Implantation? J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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HeartWare Ventricular Assist Device Implantation: Are In-Hospital Outcomes Using a Minimally Invasive Thoracotomy Approach Comparable to Conventional Sternotomy? J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Long-term use of the CentriMag® Ventricular Assist System as a right ventricular assist device: a case report. Perfusion 2011; 27:65-70. [DOI: 10.1177/0267659111424634] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Right ventricular failure (RVF) following implantation of a left ventricular assist system (LVAS) is associated with high morbidity and mortality. 1 - 4 Numerous centers have reported short-term use of the CentriMag® Ventricular Assist System (CVAS) (Levitronix LLC, Waltham, MA) for treatment of cardiogenic shock, decompensated heart failure and right ventricular failure (RVF) following LVAS implantation. 5 - 9 The present report reviews the clinical course of a patient requiring long-term right ventricular support utilizing the CVAS, following a HeartMate® II LVAS (Thoratec Corp. Pleasanton, CA) implantation. Elevated cytotoxic antibody levels complicated the patient’s treatment plan by precluding orthotropic heart transplantation. The CVAS operated for 304 days without mechanical difficulty until replaced with the HeartWare® Ventricular Assist System (HeartWare Inc. Miramar, FL).
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