Left ventricular assist device LVAD therapy has emerged as an increasingly vital facet of the treatment algorithm for advanced heart failure. Growing experience with LVAD support has led to substantial improvements in outcomes, with 1-year survival rates approaching that of cardiac transplantation. These therapeutic refinements have engendered growing interests in the potential for expanding the clinical indications for LVAD therapy to patients with less advanced heart failure.
In patients with advanced heart failure requiring LVAD support, the performance of the RV has continued to be a major determinant of short and long term outcomes. The overall performance of the RV depends on the ability of the pathologically diseased RV to adapt to the changing load conditions imposed by the LVAD. In the early perioperative phase despite favorable reductions in afterload, increased preload and contractile dysfunction are the predominant players. The RV adapts and improves with prolonged support but RV function never fully recovers.
We will describe some of our medical and surgical methods to prevent and treat right ventricular failure during ventricular assist device and reveal our outcomes. |
