The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 5 , Pages 1316-1324 , May 2010

Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: Incidence, risk factors, and effect on outcomes

  • Robert L. Kormos, MD

      Affiliations

    • Heart, Lung & Esophageal Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
    • Corresponding Author InformationAddress for reprints: Robert L. Kormos, MD, FRCS, FACS, FAHA, Artificial Heart Program, Co-Director Heart Transplantation, 200 Lothrop St, Suite C-800, Pittsburgh, PA 15213.
    • ,
  • Jeffrey J. Teuteberg, MD

      Affiliations

    • Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
    • ,
  • Francis D. Pagani, MD

      Affiliations

    • Section of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
    • ,
  • Stuart D. Russell, MD

      Affiliations

    • Department of Medicine, Johns Hopkins Hospital, Baltimore, Md
    • ,
  • Ranjit John, MD

      Affiliations

    • Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minn
    • ,
  • Leslie W. Miller, MD

      Affiliations

    • Department of Cardiovascular Medicine, Washington Hospital Center, Washington, DC
    • ,
  • Todd Massey, MD

      Affiliations

    • Division of Cardiac Surgery, University of Rochester, Rochester, NY
    • ,
  • Carmelo A. Milano, MD

      Affiliations

    • Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, NC
    • ,
  • Nader Moazami, MD

      Affiliations

    • Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo
    • ,
  • Kartik S. Sundareswaran, PhD

      Affiliations

    • Thoratec Corporation, Pleasanton, Calif
    • ,
  • David J. Farrar, PhD

      Affiliations

    • Thoratec Corporation, Pleasanton, Calif
    • ,
  • HeartMate II Clinical Investigators

Received 30 July 2009 ,Revised 17 October 2009 ,Accepted 12 November 2009.

References 

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  2. The Organ Procurement and Transplantation Network Web site. Available at: http://www.optn.org. Accessed March 2009.
  3. Farrar DJ. Ventricular interactions during mechanical circulatory support. Semin Thorac Cardiovasc Surg. 1994;6:163–168
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  5. El-Banayosy A, Arusoglu L, Kizner L, Fey O, Minami K, Korfer R. Complications of circulatory assist. Perfusion. 2000;15:327–331
  6. Frazier OH, Rose EA, Oz MC, Dembitsky W, McCarthy P, Radovancevic B, et al. Multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system in patients awaiting heart transplantation. J Thorac Cardiovasc Surg. 2001;122:1186–1195
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  8. Kavarana MN, Pessin-Minsley MS, Urtecho J, Catanese KA, Flannery M, Oz MC, et al. Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem. Ann Thorac Surg. 2002;73:745–750
  9. Ochiai Y, McCarthy PM, Smedira NG, Banbury MK, Navia JL, Feng J, et al. Predictors of severe right ventricular failure after implantable left ventricular assist device insertion: analysis of 245 patients. Circulation. 2002;106(suppl 1):I198–I202
  10. Poirier VL. The HeartMate left ventricular assist system: worldwide clinical results. Eur J Cardiothorac Surg. 1997;11(suppl):S39–S44
  11. Farrar DJ, Hill JD, Pennington DG, McBride LR, Holman WL, Kormos RL, et al. Preoperative and postoperative comparison of patients with univentricular and biventricular support with the Thoratec ventricular assist device as a bridge to cardiac transplantation. J Thorac Cardiovasc Surg. 1997;113:202–209
  12. Morgan JA, John R, Lee BJ, Oz MC, Naka Y. Is severe right ventricular failure in left ventricular assist device recipients a risk factor for unsuccessful bridging to transplant and post-transplant mortality. Ann Thorac Surg. 2004;77:859–863
  13. Fitzpatrick JR, Frederick JR, Hiesinger W, Hsu VM, McCormick RC, Kozin ED, et al. Early planned institution of biventricular mechanical circulatory support results in improved outcomes compared with delayed conversion of a left ventricular assist device to a biventricular assist device. J Thorac Cardiovasc Surg. 2009;137:971–977
  14. Tsukui H, Teuteberg JJ, Murali S, McNamara DM, Buchanan JR, Winowich S, et al. Biventricular assist device utilization for patients with morbid congestive heart failure: a justifiable strategy. Circulation. 2005;112(suppl):I65–I72
  15. Dang NC, Topkara VK, Mercando M, Kay J, Kruger KH, Aboodi MS, et al. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant. 2006;25:1–6
  16. Matthews JC, Koelling TM, Pagani FD, Aaronson KD. The right ventricular failure risk score a pre-operative tool for assessing the risk of right ventricular failure in left ventricular assist device candidates. J Am Coll Cardiol. 2008;51:2163–2172
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  18. Miller LW, Pagani FD, Russell SD, John R, Boyle AJ, Aaronson KD, et al. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885–896
  19. Pagani FD, Miller LW, Russell SD, Aaronson KD, John R, Boyle AJ, et al. Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device. J Am Coll Cardiol. 2009;54:312–321
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  22. Moon MR, Bolger AF, DeAnda A, Komeda M, Daughters GT, Nikolic SD, et al. Septal function during left ventricular unloading. Circulation. 1997;95:1320–1327
  23. Kormos RL, Gasior TA, Kawai A, Pham SM, Murali S, Hattler BG, et al. Transplant candidate's clinical status rather than right ventricular function defines need for univentricular versus biventricular support. J Thorac Cardiovasc Surg. 1996;111:773–783
  24. Potapov EV, Stepanenko A, Dandel M, Kukucka M, Lehmkuhl HB, Weng Y, et al. Tricuspid incompetence and geometry of the right ventricle as predictors of right ventricular function after implantation of a left ventricular assist device. J Heart Lung Transplant. 2008;27:1275–1281
  25. Van Meter CH. Right heart failure: best treated by avoidance. Ann Thorac Surg. 2001;71(suppl):S220–S222

 Disclosures: Jeffrey Teuteberg, Stuart Russell, Leslie Miller, and Todd Massey report consulting/lecture fees and grant support from Thoratec. Francis Pagani reports grant support from Thoratec. David Farrer reports grant support, equity, and employment by Thoratec.

PII: S0022-5223(09)01475-5

doi: 10.1016/j.jtcvs.2009.11.020

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 5 , Pages 1316-1324 , May 2010

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