Right heart failure after durable left ventricular assist device implantation.

Expert review of medical devices Pub Date : 2024-03-01 Epub Date: 2024-01-19 DOI:10.1080/17434440.2024.2305362
Tamari Miller, Frederick M Lang, Ashkon Rahbari, Kleanthis Theodoropoulos, Veli K Topkara
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Abstract

Introduction: Right heart failure (RHF) is a well-known complication after left ventricular assist device (LVAD) implantation and portends increased morbidity and mortality. Understanding the mechanisms and predictors of RHF in this clinical setting may offer ideas for early identification and aggressive management to minimize poor outcomes. A variety of medical therapies and mechanical circulatory support options are currently available for the management of post-LVAD RHF.

Areas covered: We reviewed the existing definitions of RHF including its potential mechanisms in the context of durable LVAD implantation and currently available medical and device therapies. We performed a literature search using PubMed (from 2010 to 2023).

Expert opinion: RHF remains a common complication after LVAD implantation. However, existing knowledge gaps limit clinicians' ability to adequately address its consequences. Early identification and management are crucial to reducing the risk of poor outcomes, but existing risk stratification tools perform poorly and have limited clinical applicability. This is an area ripe for investigation with the potential for major improvements in identification and targeted therapy in an effort to improve outcomes.

耐久性左心室辅助装置植入术后的右心衰竭。
导言:右心衰竭(RHF)是众所周知的左心室辅助装置(LVAD)植入术后并发症,预示着发病率和死亡率的增加。在这种临床环境下,了解右心衰竭的机制和预测因素可为早期识别和积极治疗提供思路,从而将不良后果降至最低。目前有多种药物疗法和机械循环支持方案可用于治疗 LVAD 术后 RHF:我们回顾了 RHF 的现有定义,包括其在耐用 LVAD 植入情况下的潜在机制以及目前可用的医疗和设备疗法。我们使用 PubMed 进行了文献检索(从 2010 年到 2023 年):RHF 仍是植入 LVAD 后的常见并发症。专家观点:RHF 仍是植入 LVAD 后的常见并发症,但现有的知识缺口限制了临床医生充分应对其后果的能力。早期识别和管理是降低不良后果风险的关键,但现有的风险分层工具表现不佳,临床适用性有限。这是一个研究时机已经成熟的领域,有可能在识别和针对性治疗方面取得重大进展,从而改善预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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