Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec;27(12):1286-92.
doi: 10.1016/j.healun.2008.09.006.

Risk score derived from pre-operative data analysis predicts the need for biventricular mechanical circulatory support

J Raymond Fitzpatrick 3rd  1 , John R Frederick, Vivian M Hsu, Elliott D Kozin, Mary Lou O'Hara, Elan Howell, Deborah Dougherty, Ryan C McCormick, Carine A Laporte, Jeffrey E Cohen, Kevin W Southerland, Jessica L Howard, Mariell L Jessup, Rohinton J Morris, Michael A Acker, Y Joseph Woo
Affiliations

Risk score derived from pre-operative data analysis predicts the need for biventricular mechanical circulatory support

J Raymond Fitzpatrick 3rd et al. J Heart Lung Transplant. 2008 Dec.

Abstract

Background: Right ventricular (RV) failure after left ventricular assist device (LVAD) placement is a serious complication and is difficult to predict. In the era of destination therapy and the total artificial heart, predicting post-LVAD RV failure requiring mechanical support is extremely important.

Methods: We reviewed patient characteristics, laboratory values and hemodynamic data from 266 patients who underwent LVAD placement at the University of Pennsylvania from April 1995 to June 2007.

Results: Of 266 LVAD recipients, 99 required RV assist device (BiVAD) placement (37%). We compared 36 parameters between LVAD (n = 167) and BiVAD patients (n = 99) to determine pre-operative risk factors for RV assist device (RVAD) need. By univariate analysis, 23 variables showed statistically significant differences between the two groups (p < or = 0.05). By multivariate logistic regression, cardiac index < or =2.2 liters/min/m(2) (odds ratio [OR] 5.7), RV stroke work index < or =0.25 mm Hg . liter/m(2) (OR 5.1), severe pre-operative RV dysfunction (OR 5.0), pre-operative creatinine > or =1.9 mg/dl (OR 4.8), previous cardiac surgery (OR 4.5) and systolic blood pressure < or =96 mm Hg (OR 2.9) were the best predictors of RVAD need.

Conclusions: The most significant predictors for RVAD need were cardiac index, RV stroke work index, severe pre-operative RV dysfunction, creatinine, previous cardiac surgery and systolic blood pressure. Using these data, we constructed an algorithm that can predict which LVAD patients will require RVAD with >80% sensitivity and specificity.

PubMed Disclaimer

Comment in

References

    1. Goldstein DJ, Oz MC, Rose EA. Implantable left ventricular assist devices. N Engl J Med. 1998;339(21):1522–33. - PubMed
    1. Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. J Heart Lung Transplant. 2002;21:189–203. - PubMed
    1. Oz MC, Goldstein DJ, Pepino P, et al. Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. Circulation. 1995;92(suppl II):II–169-II-173. - PubMed
    1. Rao V, Oz MC, Flannery MA, Catanese KA, Argenziano M, Naka Y. Revised screening scale to predict survival after insertion of a left ventricular assist device. J Thorac Cardiovasc Surg. 2003;125:855–861. - PubMed
    1. Potapov EV, Loforte A, Weng Y, et al. Experience with over 1000 implanted ventricular assist devices. J Card Surg. 2008;23(3):185–94. - PubMed

MeSH terms