title: Effects of the HeartMate II continuous-flow left ventricular assist device on right ventricular function.
abstract: BACKGROUND
  Continuous-flow devices have become the standard of care for mechanical circulatory support for end-stage heart failure patients because of improved survival and durability. The effects of these devices, such as the HeartMate II (HMII) left ventricular assist device (LVAD), on right ventricular (RV) function have not been evaluated in detail. This study evaluated the incidence of RV failure, alterations in RV function, severity of tricuspid regurgitation (TR), and cardiac hemodynamics after HMII implantation.
  
  
  METHODS
  Echocardiograms (n = 22) and right heart catheterizations (n = 40) were performed before and after 4 to 6 months of HMII support in 40 bridge-to-transplant patients. Right heart failure was defined as the requirement for inotropes and/or nitric oxide requirement after LVAD implantation for >14 days or the need for right-sided mechanical circulatory support.
  
  
  RESULTS
  Overall, RV failure after HMII implantation occurred in 2 of 40 patients (5%). Significant improvements occurred in cardiac index, with reductions in right atrial pressure, RV stroke work index, tricuspid annular motion, mean pulmonary artery pressure, and pulmonary vascular resistance after HMII support. There was a trend towards reduction in TR after LVAD support (p = 0.075).
  
  
  CONCLUSIONS
  The incidence of RV failure after support with continuous-flow devices such as the HMII is low. The favorable effects of the HMII on cardiac hemodynamics result in improved RV function, improved right- and left-sided hemodynamic profiles, and a reduction in TR severity. These findings may have important implications for LVAD patients needing longer-term support.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Sangjin
authors.initials: S
authors.lastname: Lee
authors.forename: Forum
authors.initials: F
authors.lastname: Kamdar
authors.forename: Richard
authors.initials: R
authors.lastname: Madlon-Kay
authors.forename: Andrew
authors.initials: A
authors.lastname: Boyle
authors.forename: Monica
authors.initials: M
authors.lastname: Colvin-Adams
authors.forename: Marc
authors.initials: M
authors.lastname: Pritzker
authors.forename: Ranjit
authors.initials: R
authors.lastname: John
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000601:surgery*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency; D018497:Ventricular Dysfunction, Right / Q000453:epidemiology / Q000601:surgery*