Prediction, prevention, and management of right ventricular failure after left ventricular assist device implantation: A comprehensive review

Abstract

Left ventricular assist devices (LVADs) are increasingly common across the heart failure population. Right ventricular failure (RVF) is a feared complication that can occur in the early post-operative phase or during the outpatient follow-up. Multiple tools are available to the clinician to carefully estimate the individual risk of developing RVF after LVAD implantation. This review will provide a comprehensive overview of available tools for RVF prognostication, including patient-specific and right ventricle (RV)-specific echocardiographic and hemodynamic parameters, to provide guidance in patient selection during LVAD candidacy. We also offer a multidisciplinary approach to the management of early RVF, including indications and management of right ventricular assist devices in this setting to provide tools that help managing the failing RV.

Keywords: heart failure (HF); hemocompatibility adverse events (HRAE); left ventricular assist device (LVAD); right ventricle (RV); right ventricular assist device (RVAD); right ventricular failure (RVF).