title: Mechanical circulatory support for the right ventricle in the setting of a left ventricular assist device.
abstract: Right ventricular failure is a difficult problem to manage and typically carries a dismal prognosis. In the setting of post-left ventricular assist device implantation (LVAD), right ventricular dysfunction both in the early and late stages is of particularly high incidence and concern. There are currently no agreed upon preoperative algorithms to predict patients at risk for this problem, thus adding another level of complexity to treatment. Furthermore, there is no current technology available for chronic right ventricular support and the devices currently in use are LVADS modified to adapt to the right circulatory system. This review provides an overview of right ventricular failure, particularly after LVAD implantation, and describes the survival outcomes and continued challenges in this area.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Avenue, Desk J4-1, Cleveland, OH 44195, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Steffen
authors.forename: M Scott
authors.initials: MS
authors.lastname: Halbreiner
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
authors.forename: Edward G
authors.initials: EG
authors.lastname: Soltesz
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
mesh_terms: D001243:Assisted Circulation / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D019317:Evidence-Based Medicine; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000401:mortality* / Q000517:prevention & control*
keywords: heart failure; mechanical circulatory support; right ventricular failure; right ventricular recovery; ventricular assist devices