Right Heart Failure in LVAD patients: Prevention and ...
Christian Bermudez MD.
Associate Professor
Director Thoracic Transplantation
Division Cardiac Surgery
Department of Surgery
University of Pennsylvania
Right Heart Failure in LVAD patients:
Prevention and Management.
Conflict of Interest
? No Financial Disclosures.
Interaction RV and LVAD support
INTERMACS definition of RVF
? Symptoms and Signs of persistent RVF following LVAD implantation characterized by :
? Elevated CVP documented by:
¡ð Right atrial pressure >16 mmHg on right heart catheterization
¡ð Significantly dilated inferior vena cava with no inspiratory variation on echocardiography
¡ð Elevated jugular venous pressure
? Manifestations of elevated CVP characterized by:
¡ð Peripheral edema(>2+)
¡ð Ascites or hepatomegaly on exam or diagnostic imaging
¡ð Laboratory evidence of worsening hepatic (total bilirubin >2.0 mg/dl) or renal dysfunction
(creatinine >2.0 mg/dl)
STS/EACTS Latin America Cardiovascular Surgery Conference 2018
4
Severity of Post-op RV Failure
2.6 fold increase in mortality at 6 months
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