Sharon HF Seminar Practice-1-03 24 HF SEM - ADVANCE HF - RV HF

03 24 HF SEM - ADVANCE HF - RV HF - Houston UPDATE

Pdf Summary

This document addresses the issue of right ventricular (RV) failure following left ventricular assist device (LVAD) placement. RV failure can occur early or late post-operatively, leading to reduced cardiac output and elevated filling pressures. The pathophysiology involves changes in RV afterload, preload, contractility, and RV-PA coupling. Predictors of RV failure include pre-operative RV dysfunction and certain hemodynamic parameters. Management strategies focus on optimizing preload, reducing afterload, and considering RV mechanical circulatory support if needed. Treatments include diuresis, inotropes, and strategies to avoid systemic hypotension. It is crucial to address RV failure promptly to prevent worse outcomes such as organ dysfunction and mortality. In summary, post-LVAD RV failure is common, serious, and challenging to predict, but steps can be taken to mitigate the risk through careful patient selection, operative techniques, and post-operative care.

Keywords

right ventricular failure

RV failure

left ventricular assist device

LVAD placement

cardiac output

filling pressures

RV afterload

RV preload

RV contractility

RV-PA coupling