| Tricuspid incompetence and geometry of the right ventricle as predictors of right ventricular function after implantation of a left ventricular assist device. | |
| | |
MedLine Citation:
|
PMID: 19059106 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Implantation of a left ventricular assist device (LVAD) is an established treatment for end-stage heart failure. Right ventricular (RV) dysfunction develops in 20% to 50% of patients after LVAD implantation, leading to prolonged ICU stay and elevated mortality. However, the prediction of RV failure remains difficult. METHODS: The pre-operative echocardiographic parameters, tricuspid incompetence (TI), RV end-diastolic diameter (cut-off >35 mm), RV ejection fraction (cut-off <30%), right atrial dimension (cut-off >50 mm) and short/long axis ratio (cut-off >0.6), were analyzed retrospectively in 54 patients. Patients were divided into two groups. One group consisted of patients with RV failure (n = 9), as defined by the presence of two of the following criteria in the first 48 hours after surgery: mean arterial pressure < or =55 mm Hg; central venous pressure > or =16 mm Hg; mixed venous saturation < or =55%; cardiac index <liters/min/m(2); inotropic support score >20 units; or need for an RVAD. The other patients comprised the non-RV-failure group (n = 45). RESULTS: The RV failure group had a significantly higher short/long axis ratio of the RV (0.63 vs 0.52, p = 0.03; odds ratio 4.4, p = 0.011). For patients with a short/long axis ratio of the RV of <0.6, RV failure occurred in 7% of patients, as compared with 50% for patients with a ratio > or =0.6 (p = 0.013). Among patients with TI Grade III or IV, 75% developed RV failure as compared with 12% in patients with TI Grade I or II (p = 0.054). The odds ratio for RV failure after LVAD implantation for TI Grade III or IV was 4.7 (p = 0.012). CONCLUSIONS: Pre-operative evaluation of tricuspid incompetence and RV geometry may help to select patients who would benefit from biventricular support. |
| | |
Authors:
|
Evgenij V Potapov; Alexander Stepanenko; Michael Dandel; Marian Kukucka; Hans B Lehmkuhl; Yuguo Weng; Felix Hennig; Thomas Krabatsch; Roland Hetzer |
Related Documents
:
|
18186776 - Is echo-determined left ventricular geometry associated with ventricular filling and mi... 16545646 - Population-based analysis of sudden cardiac death with and without left ventricular sys... 19958606 - Olfactory bulb volume in taiwanese patients with posttraumatic anosmia. 17344326 - Measurement of left ventricular dyssynchrony in patients with ischaemic cardiomyopathy:... 15301886 - Utility of transesophageal atrial pacing in the diagnostic evaluation of patients with ... 18081916 - Tilt table testing in patients with suspected epilepsy. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 27 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2008 Dec |
Date Detail:
|
Created Date: 2008-12-08 Completed Date: 2009-06-19 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
|
Languages: eng Pagination: 1275-81 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. potapov@dhzb.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Blood Pressure Echocardiography Equipment Design Female Heart Ventricles / physiopathology*, surgery*, ultrasonography Heart-Assist Devices* / classification Humans Male Middle Aged Patient Selection Retrospective Studies Stroke Volume Treatment Failure Treatment Outcome Tricuspid Valve Insufficiency / physiopathology*, surgery*, ultrasonography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular...
Next Document: Changes in regulatory microRNA expression in myocardium of heart failure patients on left ventricula...