Predictors of Right Ventricular Failure after Left Ventricular Assist Device Implantation

ABSTRACT: Purpose: The purpose of this article is to review the methods of predicting right ventricular failure (RVF) in patients undergoing left ventricular assist device (LVAD) placement. Method: A literature search was conducted on PubMed using the search terms right ventricular failure, post-LVAD, and predictors. The search was conducted further using search terms Michigan score, right ventricular failure risk score (RVFRS), Kormos, CRITT score, Penn Score, Utah Right Ventricular Score, Pittsburgh Decision Tree, Interagency Registry of Mechanical Circulatory Support (INTERMACS), and European Registry for Patients with Mechanical Circulatory Support (EUROMACS) in combination with Right Ventricular Failure (RVF) and Left Ventricular Assist Device (LVAD). This yielded 21 relevant articles that serve as the basis of this review. Results: Previously established scoring methods remain unable to be universally applicable to predicting RVF after LVAD implant owing to several variations across studies. However, are several repeat variables across studies that are predictive of RVF after LVAD implantation warranting further investigation. Conclusion: Right ventricular failure is a significant complication associated with higher rates of postoperative mortality, worsening end organ dysfunction, and increased length of hospital stays after LVAD implantation. Further research into determining clinical predictors of RV failure to create a universally applicable standardized risk scoring system in this patient population is paramount to improving post-operative outcomes. Keywords: LVAD, RVF, predictors, Michigan Score, Penn Score, RVFRS, Utah Score, Kormos, CRITT, EUROMACS, Pittsburgh Decision Tree, Right Ventricular Failure, post-LVAD