Right Ventricular Failure—A Continuing Problem in

Authors: Ranjit John Sangjin Lee Peter Eckman Kenneth Liao

Publish Date: 2010/09/01

Volume: 3, Issue: 6, Pages: 604-611

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Abstract

The discrepancy between the limited availability of donor hearts and the everincreasing number of patients with heart failure has led to the increasing use of left ventricular assist devices LVAD as a bridge to transplant One of the main complications inherent following institution of LVAD therapy is right ventricular RV failure manifested by the need for inotropic and/or nitric oxide support 14 days after LVAD implant and/or the need for rightsided mechanical circulatory support RV failure is a major contributor of significant morbidity and mortality after LVAD placement The complex pathophysiology of RV failure which could potentially be related to RV myocardial dysfunction interventricular dependence and RV afterload has led to inconsistencies in predicting risk factors for RV dysfunction Several strategies have evolved over the years of experience with mechanical circulatory support that have aimed to avoid as well as reduce the incidence of RV failure It is imperative that patients who definitely need biventricular support are identified Despite the numerous risk factors identified in many studies as well as the development of risk factor profile scores this continues to be a challenging problem However the lower incidence of RV failure following LVAD in the current era is encouraging suggesting a favorable relationship between RV unloading and function and continuousflow physiology

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