Left Ventricular Assist Device Implantation in Patients With Optimal and Borderline Echocardiographic Assessment of Right Ventricle Function

Background

Left ventricular assist devices (LVADs) are used for treatment of end-stage heart failure. Outcomes are dependent on right ventricle (RV) function. Prediction of RV function after LVAD implantation is crucial for device selection and patient outcome.The aim of our study was to compare early LVAD course in patients with optimal and borderline echocardiographic parameters of RV function.

Material and methods

We retrospectively reviewed 24 male patients with LVAD implantation. The following echocardiographic data of RV function were collected: FAC (fractional area change) with optimal value?>?20%, tricuspid annulus plane systolic excursion?>15 mm, RV diameter?

Results

Echocardiography parameters differed significantly between groups 1 and 2 according to FAC (31.8% vs 24.08%; P?=?.005), RV4 (45.08 mm vs 51.69 mm; P?=?.02), and RV/LV ratio (0.6 vs 0.7; P?=?.009).Patients did not differ according to course of disease, comorbidities before implantation, or complications. One patient from each group died. Patients in group 2 experienced more pulmonary hypertension, required increased doses of catecholamines, and stayed in the intensive care unit longer. No RV dysfunction was noted.

Conclusions

Borderline FAC, tricuspid annulus plane systolic excursion, and RV4 add RV/LV ratio prolonged recovery after LVAD implantation even with no RV failure. Parameters chosen for qualification are in safe ranges.