Effects of the HeartMate II continuous-flow left ventricular assist device on right ventricular function

Sangjin Lee, Forum Kamdar, Richard Madlon-Kay, Andrew Boyle, Monica Colvin-Adams, Marc Pritzker, Ranjit John

Research output: Contribution to journalArticlepeer-review

86 Scopus citations

Abstract

Background: Continuous-flow devices have become the standard of care for mechanical circulatory support for end-stage heart failure patients because of improved survival and durability. The effects of these devices, such as the HeartMate II (HMII) left ventricular assist device (LVAD), on right ventricular (RV) function have not been evaluated in detail. This study evaluated the incidence of RV failure, alterations in RV function, severity of tricuspid regurgitation (TR), and cardiac hemodynamics after HMII implantation. Methods: Echocardiograms (n = 22) and right heart catheterizations (n = 40) were performed before and after 4 to 6 months of HMII support in 40 bridge-to-transplant patients. Right heart failure was defined as the requirement for inotropes and/or nitric oxide requirement after LVAD implantation for >14 days or the need for right-sided mechanical circulatory support. Results: Overall, RV failure after HMII implantation occurred in 2 of 40 patients (5%). Significant improvements occurred in cardiac index, with reductions in right atrial pressure, RV stroke work index, tricuspid annular motion, mean pulmonary artery pressure, and pulmonary vascular resistance after HMII support. There was a trend towards reduction in TR after LVAD support (p = 0.075). Conclusions: The incidence of RV failure after support with continuous-flow devices such as the HMII is low. The favorable effects of the HMII on cardiac hemodynamics result in improved RV function, improved right- and left-sided hemodynamic profiles, and a reduction in TR severity. These findings may have important implications for LVAD patients needing longer-term support.

Original languageEnglish (US)
Pages (from-to)209-215
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number2
DOIs
StatePublished - Feb 2010

Bibliographical note

Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.

Keywords

  • heart failure
  • right ventricular function
  • tricuspid annular motion
  • ventricular assist device

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