Abstract
Purpose Right heart failure (RHF) after left ventricular assist device (LVAD) implantation is a significant cause of morbidity and mortality. Multiple factors have been identified in order to predict early RHF, though information is scarce regarding late RHF. The aim of this study was to analyse and identify predictors of late RHF in LVAD patients. Methods A retrospective analysis of adult patients who underwent HeartWare-VAD implantation from 2009 to 2017 in a single-centre was performed. Late RHF was defined as RHF after 30 days of implantation requiring hospital admission. Clinical data, echocardiographic and haemodynamic parameters before implantation, data regarding the early post-operative phase and echocardiographic parameters at discharge were analysed. Results A total of 22 (10.7%) patients from 206 implantations developed late RHF during follow-up. Time to first RHF admission was 202.5 (IQR 130-682) days. Patients presenting with late RHF had a higher incidence of pre-operative significant tricuspid regurgitation (p Conclusion Late RHF was more prevalent in patients with dilated cardiomyopathy or congenital heart disease, and is not predicted by early RHF. Significant tricuspid regurgitation at discharge post-implantation predicted the occurrence of late RHF. Prospective studies are needed to determine whether tricuspid valve interventions may reduce late RHF.
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