Preoperative Risk Factors for Mortality After Biventricular Assist Device Implantation

Firas Zahr, Yoshio Ootaki, Randall C. Starling, Nicholas G. Smedira, Mohamad Yamani, Lucy Thuita, Kiyotaka Fukamachi

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background: A right ventricular assist device is a treatment option for patients with severe right ventricular failure after left ventricular assist device (LVAD) implantation. Recognition of risk factors for mortality after biventricular assist device (BiVAD) implantation is important for patient selection and optimal outcomes. Methods: We reviewed our experiences between 1991 and 2005 in 44 patients who were supported by both an LVAD and a right ventricular assist device. Results: Thirteen patients (30%) survived until heart transplantation, and 31 patients (70%) died while on support. The multivariate analysis shows that post-LVAD extracorporeal membrane oxygenation and worsening renal function are associated with the highest postoperative mortality. The univariate analysis also included previous thoracic surgery and ischemic cardiomyopathy as potential preoperative indicators for poor outcome after BiVAD implants. No differences were observed in the rates for the need of preoperative support with a ventilator, an intra-aortic balloon pump, or extracorporeal membrane oxygenation, or in the rates of postoperative complications between survivors and nonsurvivors. Conclusions: BiVAD implantation remains one of the challenges in treating severe heart failure. Previous cardiac surgery, elevated creatinine, and post-LVAD extracorporeal membrane oxygenation were risk factors for mortality after BiVAD implantation. Dialated Cardiomyopathy on the other hand was associated with a more favorable outcome.

Original languageEnglish (US)
Pages (from-to)844-849
Number of pages6
JournalJournal of Cardiac Failure
Volume14
Issue number10
DOIs
StatePublished - Dec 1 2008

Keywords

  • Heart failure
  • right ventricular failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Zahr, F., Ootaki, Y., Starling, R. C., Smedira, N. G., Yamani, M., Thuita, L., & Fukamachi, K. (2008). Preoperative Risk Factors for Mortality After Biventricular Assist Device Implantation. Journal of Cardiac Failure, 14(10), 844-849. https://doi.org/10.1016/j.cardfail.2008.08.009