A Useful Scoring System For Predicting Right Ventricular Assist Device Requirement Among Patients with a Paracorporeal Left Ventricular Assist Device.

A Useful Scoring System For Predicting Right Ventricular Assist Device Requirement Among Patients with a Paracorporeal Left Ventricular Assist Device. Int Heart J. 2018 Aug 29;: Authors: Nitta D, Kinugawa K, Imamura T, Amiya E, Hatano M, Kinoshita O, Nawata K, Ono M, Komuro I Abstract Ventricular assist devices (VADs) have become an important therapy for advanced heart failure, however, the prognosis of those who receive a biventricular assist device (BiVAD) is still poor. We enrolled 70 patients who underwent paracorporeal VAD (Nipro-VAD®) implantation between 2004 and 2015 and studied the preoperative risk factors, including hemodynamic parameters for RVAD requirement. Furthermore, 2-year survival was compared between the BiVAD group and LVAD only group. Fourteen patients (20%) required RVAD. The BiVAD group had a significantly smaller left ventricular diastolic/systolic dimension, lower mean pulmonary artery wedge pressure (PAWP), lower cardiac index (CI), higher pulmonary vascular resistance (PVR), higher mean right atrial pressure (RAP), lower pulmonary artery pulsatility index (PAPi), lower right ventricular stroke work index (RVSWI), and higher mean RAP/mean PAWP ratio preoperatively. After multivariate analysis, only PVR > 4.5 Wood units: WU (P = 0.013, odds ratio: OR 7.9) and mean RAP/mean PAWP > 0.8 (P < 0.001, OR 14.4) were significant predictors for RVAD requirement. From these odds ratios, we assigned 1 point t...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research