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Predictors and impact of right heart failure severity following left ventricular assist device implantation

  
@article{JTD24799,
	author = {Ronald D. Baxter and Kristen M. Tecson and Sasha Still and Justin D. G. Collier and Joost Felius and Susan M. Joseph and Shelley A. Hall and Brian Lima},
	title = {Predictors and impact of right heart failure severity following left ventricular assist device implantation},
	journal = {Journal of Thoracic Disease},
	volume = {11},
	number = {Suppl 6},
	year = {2018},
	keywords = {},
	abstract = {Background: Right heart failure (RHF) is a well-known consequence of left ventricular assist device (LVAD) placement, and has been linked to negative surgical outcomes. However, little is known regarding risk factors associated with RHF. This article delineates pre- and intra-operative risk factors for RHF following LVAD implantation and demonstrates the effect of RHF severity on key surgical outcomes.
Methods: We performed a retrospective analysis of consecutive LVAD patients treated at our center between 2008 and 2016. RHF was categorized using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) definition of none/mild, moderate, severe, and acute-severe. We constructed a predictive model using multivariable logistic regression and performed a competing risks analysis for survival stratified by RHF severity.
Results: Of 202 subjects, 52 (25.7%) developed moderate or worse RHF. Cardiopulmonary bypass (CPB) time and nadir hematocrit contributed jointly to the model of RHF severity (moderate or worse vs. none/mild; area under the curve =0.77). Postoperative length of stay (LOS) was shortest in the non/mild group and longest in the acute-severe group (median 13 vs. 29.5 days; P},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/24799}
}