Timing of temporary right ventricular assist device insertion for severe right heart failure after left ventricular assist device implantation

Koji Takeda, Yoshifumi Naka, Jonathan A. Yang, Nir Uriel, Paolo C. Colombo, Ulrich P. Jorde, Hiroo Takayama

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Data on how the timing of a temporary right ventricular assist device (RVAD) insertion affects outcome are limited in patients receiving left ventricular assist device (LVAD). Of the 282 patients who underwent LVAD placement between January 2000 and November 2010, 40 (14%) required concomitant (n = 26) or delayed (n = 14) RVAD insertion as temporary support. We analyzed early and 1-year outcomes. Preoperative variables were similar in the concomitant and delayed RVAD groups. The hospital mortality rate was approximately 50% in both groups (p = 0.82). The 1-year actuarial survival was similar in both groups (p = 0.42). Patients who required RVAD support had higher in-hospital mortality and worse 1-year survival rates than those who received LVAD only (48% vs. 9.5%, p < 0.0001; 40% vs. 82%, p < 0.0001). Multivariate logistic regression analysis indicated RVAD use as a significant risk factor for 1-year mortality (odds ratio, 18; p = 0.0003; 95% confidence interval, 3.765-86.74). Timing of temporary RVAD insertion did not affect overall survival. Necessity of RVAD support is associated with significantly worse early and late mortality at any rate. The decision to place the RVAD can be made once it is clinically necessary.

Original languageEnglish (US)
Pages (from-to)564-569
Number of pages6
JournalASAIO Journal
Volume59
Issue number6
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Heart Failure
Regression analysis
Logistics
Hospital Mortality
Mortality
Survival

Keywords

  • heart failure
  • right ventricle
  • ventricular assist device

ASJC Scopus subject areas

  • Biophysics
  • Biomaterials
  • Bioengineering
  • Biomedical Engineering
  • Medicine(all)

Cite this

Timing of temporary right ventricular assist device insertion for severe right heart failure after left ventricular assist device implantation. / Takeda, Koji; Naka, Yoshifumi; Yang, Jonathan A.; Uriel, Nir; Colombo, Paolo C.; Jorde, Ulrich P.; Takayama, Hiroo.

In: ASAIO Journal, Vol. 59, No. 6, 11.2013, p. 564-569.

Research output: Contribution to journalArticle

Takeda, Koji ; Naka, Yoshifumi ; Yang, Jonathan A. ; Uriel, Nir ; Colombo, Paolo C. ; Jorde, Ulrich P. ; Takayama, Hiroo. / Timing of temporary right ventricular assist device insertion for severe right heart failure after left ventricular assist device implantation. In: ASAIO Journal. 2013 ; Vol. 59, No. 6. pp. 564-569.
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