The overall objective of this pilot analysis is to characterize the hemodynamic changes that occur during implantation of a left ventricular assist device (LVAD) in patients with advanced heart failure - specifically, how right ventricular function is compromised as a result of LVAD implantation.
individuals ≥ 18 years of age with severe heart failure (HF) and who have been approved by the advanced HF selection committee for LVAD implantation.
Exclusion Criteria:
Patients with pre-existing right ventricular (RV) dysfunction/failure, defined as:
Imaging evidence of moderate-severe RV dysfunction on echocardiography
Hemodynamic evidence of RV dysfunction with:
a right-atrial pressure (RAP): pulmonary capillary wedge pressure (PCWP) ratio of ≥ 0.67 (note: this index compares pressures on the right [RAP] and left [PCWP] side of the heart; an RAP/PCWP ratio ≥ 0.67 provides hemodynamic evidence of RV dysfunction. Clinical evidence of preexisting RV dysfunction, as indicated by significant (3-4+ peripheral edema) and/or elevated jugular venous pressures on clinical examination. Patients with end-stage renal disease requiring hemodialysis Patients requiring temporary hemodynamic support prior to LVAD implantation with temporary LVADs, and/or veno-arterial extracorporeal membrane oxygenators ("ECMO"). Planned concurrent implantation of right ventricular assist device
