Late Right Heart Failure After Left Ventricular Assist Device Implantation

JACC Heart FailPublished 31 May 2023

Study context

Population: Patients with long-term left ventricular assist device (LVAD) support

As reported in the abstract

Late RHF after LVAD implantation: definition, pathophysiology, prevention and management (narrative review)

Late right heart failure (RHF) in long-term LVAD support is associated with decreased survival and increased adverse events such as GI bleeding and stroke
Progression of right ventricular (RV) dysfunction to late RHF depends on pre-existing RV dysfunction severity, persistent or worsening left- or right-sided valvular disease, pulmonary hypertension, inadequate or excessive LV unloading and/or progression of underlying cardiac disease
De novo RHF in a subset leads to increased diuretic requirement, arrhythmias, renal and hepatic dysfunction and HF hospitalisations
Potential management: optimisation of RV preload and afterload, neurohormonal blockade, LVAD speed optimisation, treatment of concomitant valvular disease

Late Right Heart Failure After Left Ventricular Assist Device Implantation. JACC Heart Fail. Published 31 May 2023. doi:10.1016/j.jchf.2023.04.014

Summarised from the published abstract; every number is checked against it