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Right ventricular dysfunction in left ventricular assist device candidates: is it time to change our prospective?
Sciaccaluga, Carlotta; Procopio, Maria Cristina; Potena, Luciano; Masetti, Marco; Bernazzali, Sonia; Maccherini, Massimo; Landra, Federico; Righini, Francesca Maria; Cameli, Matteo; Valente, Serafina.
Afiliación
  • Sciaccaluga C; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy. carlotta.sciaccaluga@gmail.com.
  • Procopio MC; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
  • Potena L; Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Masetti M; Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Bernazzali S; Department of Cardiac Surgery, University of Siena, Siena, Italy.
  • Maccherini M; Department of Cardiac Surgery, University of Siena, Siena, Italy.
  • Landra F; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
  • Righini FM; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
  • Cameli M; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
  • Valente S; Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
Heart Fail Rev ; 29(2): 559-569, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38329583
ABSTRACT
The use of left ventricular assist devices (LVAD) has significantly increased in the last years, trying to offer a therapeutic alternative to heart transplantation, in light also to the significant heart donor shortage compared to the growing advanced heart failure population. Despite technological improvements in the devices, LVAD-related mortality is still fairly high, with right heart failure being one of the predominant predictors. Therefore, many efforts have been made toward a thorough right ventricular (RV) evaluation prior to LVAD implant, considering clinical, laboratory, echocardiographic, and invasive hemodynamic parameters. However, there is high heterogeneity regarding both which predictor is the strongest as well as the relative cut-off values, and a consensus has not been reached yet, increasing the risk of facing patients in which the distinction between good or poor RV function cannot be surely reached. In parallel, due to technological development and availability of mechanical circulatory support of the RV, LVADs are being considered even in patients with suboptimal RV function. The aim of our review is to analyze the current evidence regarding the role of RV function prior to LVAD and its evaluation, pointing out the extreme variability in parameters that are currently assessed and future prospective regarding new diagnostic tools. Finally, we attempt to gather the available information on the therapeutic strategies to use in the peri-operative phase, in order to reduce the incidence of RV failure, especially in patients in which the preoperative evaluation highlighted some conflicting results with regard to ventricular function.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Disfunción Ventricular Derecha / Insuficiencia Cardíaca Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Heart Fail Rev Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Trasplante de Corazón / Disfunción Ventricular Derecha / Insuficiencia Cardíaca Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Heart Fail Rev Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos