title: Survival after left ventricular assist device with and without temporary right ventricular support.
abstract: BACKGROUND
  Right ventricular (RV) failure after the insertion of a left ventricular assist device (LVAD) historically results in poor outcomes. Patients requiring temporary RV support after LVAD insertion are a heterogeneous group of patients consisting of those in cardiogenic shock after myocardial infarction, to those with chronic decompensated heart failure. For patients requiring biventricular support, we have used a hybrid system consisting of a HeartMate II LVAD and CentriMag right ventricular assist device (RVAD). The purpose of this study was to determine the 1-year survival in patients requiring isolated LVAD and patients requiring biventricular support.
  
  
  METHODS
  All patients who underwent HeartMate II LVAD alone or in conjunction with a temporary CentriMag RVAD were examined from 2006 to 2011. Preoperative demographics, operative outcomes, and survival were analyzed.
  
  
  RESULTS
  A total of 139 patients required HeartMate II insertion; 34 (24%) required biventricular support at the time of HeartMate II implantation. The mean duration of biventricular support was 17 ± 11.9 days (range, 6 to 56 days) with 91.8% (n = 31) of RVADs successfully explanted. Survival to hospital discharge was not different between groups (95.2 versus 88.2%; p = 0.2). However, 1-year survival was significantly greater in patients who required isolated HeartMate II LVAD (87% versus 77%; p = 0.03).
  
  
  CONCLUSIONS
  Biventricular support using a HeartMate II LVAD and CentriMag RVAD resulted in limited mortality at hospital discharge. However biventricular dysfunction does not have a favorable outcome at 1 year when compared with patients requiring isolated HeartMate II.
authors.affiliation: Division of Cardiac Surgery, University of Rochester, Rochester, New York.
authors.forename: John F
authors.initials: JF
authors.lastname: Lazar
authors.forename: Michael F
authors.initials: MF
authors.lastname: Swartz
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Schiralli
authors.forename: Marabel
authors.initials: M
authors.lastname: Schneider
authors.forename: Brian
authors.initials: B
authors.lastname: Pisula
authors.forename: William
authors.initials: W
authors.lastname: Hallinan
authors.forename: George L
authors.initials: GL
authors.lastname: Hicks
authors.forename: H Todd
authors.initials: HT
authors.lastname: Massey
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000628:therapy; D006352:Heart Ventricles / Q000503:physiopathology; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000401:mortality
keywords: 27