Faculty Collaboration Database

Association of preoperative duration of inotropy on prevalence of right ventricular failure following LVAD implantation. ESC Heart Fail 2020 Aug;7(4):1949-1955

Date

06/12/2020

Pubmed ID

32526807

Pubmed Central ID

PMC7373884

DOI

10.1002/ehf2.12791

Scopus ID

2-s2.0-85086232769 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

AIMS: 20% to 40% of left ventricular assist device (LVAD) device implantations are complicated by right ventricular (RV) failure that results in significant morbidity and mortality. We hypothesized that the duration on milrinone infusion is an independent risk factor for RV failure following LVAD implantation.

METHODS AND RESULTS: Retrospective demographic, clinical and hemodynamic data were collected on all adults with ACC/AHA stage D heart failure on intravenous milrinone who underwent LVAD implantation between 2012 and 2019. Patients (n = 104) were divided into two groups, those on milrinone <30 days (STM, n = 55) vs. ≥30 (LTM, n = 49). The primary endpoint was the prevalence of RV failure (need for inotropic support for more than 14 days or RV assist device) within 30 days post-LVAD implantation. There were no significant differences between STM and LTM patients with respect to demographic, echocardiographic, right heart catheterization data, or baseline medications. The mean age of patients was 55.6 ± 12 years (70% male patients). Mean duration on milrinone was 13.7 vs. 81.0 days in STM and LTM, respectively. Forty-five (43.3%) patients developed RV failure. LTM had higher prevalence of RV failure with odds ratio (OR) = 5.04 (95% CI 2.18-11.68, P = 0.0002). After adjusting for age, gender, and co-morbidity count, the OR was 6.33 (95% CI 2.51-15.93), P < 0.0001.

CONCLUSIONS: In this retrospective study of ACC/AHA stage D HF patients, longer duration of milrinone infusion was associated with higher prevalence of RV failure after LVAD implantation.

Author List

Benjamin MM, Sundararajan S, Sulaiman S, Miles B, Walker RJ, Durham L, Kohmoto T, Joyce DL, Ishizawar D, Gaglianello N, Mohammed A

Authors

Lucian A. Durham MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Heart Failure
Heart-Assist Devices
Humans
Male
Middle Aged
Prevalence
Retrospective Studies
Ventricular Dysfunction, Right