Preoperative hemodynamics as predictors of right heart failure post-left ventricular assist device

Abstract Background Mechanical circulatory support has garnered significant popularity as both a bridge to transplant well destination therapy for patients with end-stage heart failure. Right failure (RHF) is devastating complication after LVAD placement and very unpredictable. Assisted circulation of the left ventricle (LV) an device could unmask underlying RHF. However, otherwise healthy right ventricles (RVs) can develop RHF due poor adaptation new filling pressures altered hemodynamics. It been proposed that preoperative volumetric measurements in pulmonary systemic vasculature may serve indicators risk implantation. The aim this study examine potential relationship hemodynamic values such artery pulsatility index (PAPi) ratio central venous pressure wedge (CVP/PWP) predictors post placement. Methods We retrospectively reviewed undergoing initially planned isolated implantation or without concomitant procedures our institution from January 1, 2017 June 12, 2020. Data were gathered records, echocardiographic interpretations, clinical notes. Patients who had but data available within 14 days operation excluded. Univariable analysis was performed. Results Of 114 received surgery, 70 (61.4%) experienced first 7 postoperatively. PAPi did not correlate significantly vs non-RHF among recipients (3.1 ± 2.1 vs. 3.8 3.4 P = 0.21). Pre-op CVP/PWP differ between (0.4 0.2 0.5 0.8 0.28). There nonsignificant correlation elevated pre-op PWP those without, OR 1.05 (95% CI : 1.00, 1.10). systolic (SysPAP) post-LVAD compared (51.3 12.3 47.2 13.0, 0.09). Conclusion Preoperative variables show predicting Acute remains complex medical entity. Several studies have devised multivariable scores; however, their performance limited. Despite widespread use hemodynamics scores, suggests these scores are accurate would suggest, particularly especially morbid patient populations. More prospective needed accurately demonstrate how predict help prevent catastrophic complication.