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Editorial
. 2023 Jun;165(6):2126-2131.
doi: 10.1016/j.jtcvs.2022.03.025. Epub 2022 Apr 7.

Rescuing the right ventricle: A conceptual framework to target new interventions for patients receiving a durable left ventricular assist device

Michael J Pienta  1 , Pierre-Emmanuel Noly  1 , Allison M Janda  2 , Paul C Tang  1 , Abbas Bitar  3 , Michael R Mathis  2 , Keith D Aaronson  3 , Francis D Pagani  1 , Donald S Likosky  4 ; Michigan Congestive Heart Failure Investigators
Collaborators, Affiliations
Editorial

Rescuing the right ventricle: A conceptual framework to target new interventions for patients receiving a durable left ventricular assist device

Michael J Pienta et al. J Thorac Cardiovasc Surg. 2023 Jun.

Abstract

Axes for future research in right heart failure after LVAD implantation.

Keywords: conceptual framework; hemodynamics; left ventricular assist device; right heart failure.

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Figures

FIGURE 1.
FIGURE 1.
Conceptual framework summarizing the interactions between patient factors, provider, system factors, and measures involved in the understanding of right heart failure in patients receiving a durable left ventricular assist device (LVAD). CBP, Cardiopulmonary bypass; RVAD, RV assist device; ICU, intensive care unit; RV, right ventricular; CVP, central venous pressure; PCWP, pulmonary capillary wedge pressure; PAPi, pulmonary artery pulsatility index; RVSWi, right ventricular stroke work index; RVEF, right ventricular ejection fraction; TAPSE, tricuspid annular plane systolic excursion; TR, tricuspid regurgitation; CMR, cardiac magnetic resonance; INR, International Normalized Ratio; TBili, total bilirubin; MAP, mean arterial pressure; ABG, arterial blood gas; DO2, oxygen delivery.
FIGURE 2.
FIGURE 2.
Axes for future research in right heart failure after left ventricular assist device (LVAD) implantation. The approach to improved understanding of right heart failure (RHF) in the setting of durable LVAD implantation will require a multidisciplinary heart team approach. Expertise in areas of cardiovascular genetics and biology, imaging, critical care, analyses of large datasets, and surgical care will be required to explore important issues. RV, Right ventricle; RVF, right ventricular failure; RV-PA, right-ventricular-pulmonary arterial; CMR, cardiac magnetic resonance; ERAS, enhanced recovery after surgery; SaO2, oxygen saturation; AP, arterial pressure; CVP, central venous pressure; Hte, hematocrit; PA, pulmonary artery; STS-Intermacs, The Society for Thoracic Surgeons-Interagency Registry for Mechanically Assisted Circulatory Support; IMACS, International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support; EuroMACS, European Registry for Patients with Mechanical Circulatory Support.
See this image and copyright information in PMC

Comment in

  • Commentary: Can we get it right?
    Whitson BA. Whitson BA. J Thorac Cardiovasc Surg. 2023 Jun;165(6):2132-2133. doi: 10.1016/j.jtcvs.2022.04.031. Epub 2022 May 2. J Thorac Cardiovasc Surg. 2023. PMID: 35690472 No abstract available.

References

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