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2014-02-27
AUTHORSJ.-J. Eulert-Grehn, T. Gromann, T. Krabatsch, A. Stepanenko, R. Hetzer, E.V. Potapov
ABSTRACTRight ventricular function is from the outset the Achilles heel of left ventricular assist device (LVAD) therapy. Predicting right ventricular failure can be difficult and consideration of various factors is necessary including the right ventricular end-diastolic dimension (RVEDD) LVEDD ratio which seems to be a suitable preoperative predictive parameter in conjunction with the clinical symptoms. If the patient is in cardiogenic shock with imminent multiorgan failure the implantation of a LVAD alone will not be sufficient to assist the whole organism. The implantation of a biventricular assist device (BVAD) or veno-arterial extracorporeal membrane oxygenation (ECMO) is needed. Should there be any delay in the recovery of the patient after LVAD implantation right ventricular dysfunction must be excluded. If the RV dysfunction is clinically significant the implantation of an RVAD should be taken into consideration before the sequelae of venous congestion and impaired perfusion evolve. A secondary implantation in an intensive care unit (ICU) has a worse prognosis. To which degree a secondary tricuspid insufficiency should be corrected at the time of LVAD implantation is matter of debate and research. More... »
PAGES205-215
http://scigraph.springernature.com/pub.10.1007/s00398-013-1057-4
DOIhttp://dx.doi.org/10.1007/s00398-013-1057-4
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