AI Article Synopsis
- High rates of right ventricular failure lead to poorer postoperative outcomes in patients with left ventricular assist devices (LVADs), with increased MELD scores indicating a higher risk for complications like RV failure and the need for additional support.
- Researchers analyzed MELD scores and outcomes in 256 LVAD patients, finding that higher MELD scores correlated with a greater likelihood of developing right heart failure and requiring right ventricular assist devices (RVAD).
- Postoperative survival rates were significantly lower for patients experiencing RV failure and those who required RVADs compared to those without RV dysfunction, highlighting the importance of MELD assessment in predicting these outcomes.
Article Abstract
High rates of right ventricular failure continue to affect postoperative outcomes in patients implanted with left ventricular assist devices (LVADs). Development of right ventricular failure and implantation with right ventricular assist devices is known to be associated with significantly increased mortality. The model for end-stage liver disease (MELD) score is an effective means of evaluating liver dysfunction. We investigated the prognostic utility of postoperative MELD on post-LVAD implantation outcomes. MELD scores, demographic data, and outcomes including length of stay, survival, and postoperative right ventricular failure were collected for 256 patients implanted with continuous flow LVADs. Regression and Kaplan-Meier analyses were used to investigate the relationship between MELD and all outcomes. Increased MELD score was found to be an independent predictor of both right heart failure and necessity for RVAD implantation (OR 1.097, CI 1.040-1.158, p = 0.001; OR 1.121, CI 1.015, p = 0.024, respectively). Patients with RV failure and who underwent RVAD implantation had reduced postoperative survival compared to patients with RV dysfunction (no RV failure = 651.4 ± 609.8 days, RV failure = 392.6 ± 444.8 days, RVAD = 89.3 ± 72.8 days; p < 0.001). In conclusion, MELD can be used to reliably predict postoperative right heart failure and the necessity for RVAD implantation. Those patients with RV failure and RVADs experience significantly increased postoperative mortality compared to those without RV dysfunction.
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| http://dx.doi.org/10.1007/s10047-015-0853-x | DOI Listing |
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