Abstract 18634: Serial Changes in Right Ventricular Geometry and Function in Patients After Left Ventricular Assist Device Implantation
Background: Left ventricular assist device (LVAD) support causes left ventricular (LV) unloading with decrease in volumes and leftward shifting on the interventricular septum. However, the contribution of LVAD to right ventricular (RV) remodelling is not clearly understood and not yet well described.
Objective: To evaluate the effect of LVAD therapy on biventricular dimensions and RV function early after implantation and mid-term follow-up.
Methods: 2D-echocardiography was performed preoperatively, immediately post-implant, and at follow-up (median of 5 months) in patients undergoing LVAD implantation. RV fractional area change, calculated as (end-diastolic area — end-systolic area)/ end-diastolic area × 100, was used to assess RV systolic function.
Results: 25 patients were included (mean age 50 years, 88% male). Tricuspid valve repair was simultaneously performed in 76% of patients. A significant and maintained reduction in both LV end-systolic and end-diastolic volumes was observed (Figure A and B). There was a trend towards a transitory increase in both RV end-diastolic and end-systolic areas, more pronounced in the end-systolic area (Figure C). Accordingly, there was a trend towards reduction in RV fractional area change immediately post-implant. However, RV dimensions and fractional area change returned to near baseline values on the follow-up echocardiography (Figure D).
Conclusion: LVAD implantation is associated with maintained reduction in LV volumes, and with transient increases in RV areas and reductions in RV function. Perioperative stunning and concomitant tricuspid annuloplasty may contribute to transient RV dysfunction after LVAD implantation.
- © 2010 by American Heart Association, Inc.