Echocardiographic Variables After Left Ventricular Assist Device Implantation Associated With Adverse Outcome

• DOI: 10.1161/circimaging.111.965335
• Publication Date: 2011-09-22T05:51:21Z
• Authors: Yan Topilsky; Tal Hasin; Jae K. Oh; Daniel D. Borgeson; Barry A. Boilson; John A. Schirger; Alfredo L. Clavell; Robert P. Frantz; Rayji Tsutsui; Mingya Liu; Simon Maltais; Sudhir S. Kushwaha; Naveen L. Pereira; Soon J. Park
• Keywords: Heart Failure; Male; Observer Variation; Stroke Volume; Middle Aged; Risk Assessment; Severity of Illness Index; Echocardiography, Doppler, Color; 3. Good health; Cohort Studies; Survival Rate; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Cause of Death; Odds Ratio; Humans; Female; Heart-Assist Devices; Hospital Mortality; Aged; Follow-Up Studies; Retrospective Studies

Background— Operative mortality after left ventricular assist device (LVAD) implantation is heavily influenced by patient selection and the technical difficulty of surgery. However, how we treat our patients LVAD setting may affect outcome beyond this period. We postulated that presence echocardiographic variables 1 month surgery suggesting appropriate degree LV unloading an adequate forward flow would be important in determining clinical outcomes initial successful implantation. Methods Results— retrospectively analyzed various examinations performed 30 days implant 76 consecutive receiving continuous for their association with a compound end point (90-day mortality, readmission heart failure, or New York Heart Association class III higher at 90-day period). The associations examined included estimated flow, without native contribution, interventricular septal position, status aortic valve opening, atrial pressure (ELAP), mitral E-wave deceleration time, ratio time to velocity (mitral index [MDI]). Four died during 30- period, 6 were readmitted 25 considered have Variables associated adverse increased ELAP (odds ratio, 1.30 [1.16–1.48]; P <0.0001), MDI <2 ms/[cm/s] 4.4 [1.22–18]; =0.02) decreased tricuspid lateral annulus 0.70 [0.48–0.95]; =0.02). A leftward deviation septum was worse 3.03 [1.21–13.3]; =0.01). Conclusions— Mortality failure appear predominantly determined evidence inefficient ventricle persistence right dysfunction. Increased LA short are mid term outcome. Leftward as well.