Right ventricular adaptation to isolated temporary left ventricular support for cardiogenic shock

Abstract Background Acute right ventricular (RV) failure is a well-described, yet not completely understood, complication of durable left assist device (LVAD) implantation. Although temporary percutaneous LVAD may have similar hemodynamic impact on the RV, evidence in this setting minimal. Purpose This study aims to assess acute adaptation RV isolated side support with Impella cardiogenic shock (CS). Methods Consecutive patients assisted an and monitored pulmonary artery catheter two tertiary centres between September 2018 November 2021 were included. Clinical data retrospectively recorded at baseline up 72 hours after implantation pLVAD analysed. Two subgroups analysis performed test chance different trend basis hemodynamics cause CS. Results Forty-eight consecutive included; median age was 61 (51.5–70.5) years, 83.3% male. 54.2% presented SCAI (Society for Cardiovascular Angiography Interventions) stage D [1], mostly due myocardial infarction (AMI-CS 56.3%). associated relevant improvement systemic perfusion (LV) loading condition (Table 1). At 24 hours, cardiac output improved from 3.4 (2.6–4.2) 4.0 (3.0–5.5) L/min, p<0.01; lactate decreased 3.2 (1.65–6.3) 1.55 (1.25–2.35) mmol/L, p<0.01. An afterload, reflected by mean arterial pressure dropping 31.5 (25–38.5) 25.5 (22–32.5) mmHg, p<0.01, toward atrial (RAP, 15.8±7.3 13.3±5.9 p=0.05) stability pulsatility index (PAPi) 1.08 (0.72–1.5) 1.19 (0.83–1.64), p=0.11. When stratifying parameters [2], significantly more pronounced RAP, RAP/pulmonary capillary wedge (PCWP) PAPi first 48 seen those who had poor 2). Thus, 48-hours no differences detectable anymore subgroup without dysfunction evaluation. CS aetiology, non-ischemic showed progressively better function than AMI-CS [median (0.85–2.89) versus 1 (0.73–1.47) AMI-CS, p=0.1; RAP/PCWP 0.68 (0.55–0.81) 0.89 (0.77–0.92) p=0.01]. Conclusion In cohort undergoing LV significant followed tendency towards function, even compromised profiles baseline. Funding Acknowledgement Type funding sources: None.