• Renan A Ferrufino, Abdulaziz Alfadhel, Luis F Gonzalez-Ciccarelli, Brian Gebhardt, Masashi Kawabori, Jamel Ortoleva, Ethan Brovman, and Frederick Cobey.
• Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA.
• J. Cardiothorac. Vasc. Anesth. 2023 Aug 1; 37 (8): 141814231418-1423.

ObjectivesTo evaluate the association of pulmonary artery diameter and pulmonary artery- to-aorta diameter ratio (PA/Ao) with right ventricular failure and mortality within 1 year after left ventricular assist device implantation.DesignThis was a retrospective observational study between March 2013 and July 2019.SettingThe study was conducted at a single, quaternary-care academic center.ParticipantsAdults (≥18 years old) receiving a durable left ventricular assist device (LVAD). Inclusion if (1) a chest computed tomography scan was performed within 30 days before the LVAD and (2) a right and left heart catheterization was completed within 30 days before the LVAD.InterventionsA left ventricular assist device was used for intervention.Measurements And Main ResultsA total of 176 patients were included in this study. Median PA diameter and PA/Ao ratio were significantly greater in the severe right ventricular failure (RVF) group (p = 0.001, p < 0.001, respectively). Receiver operating characteristic analysis revealed PA/Ao and RVF as predictors for mortality (area under the curve = 0.725 and 0.933, respectively). Logistic regression analysis-predicted probability gave a PA/Ao ratio cutoff point of 1.04 (p < 0.001). Survival probability was significantly worse in patients with a PA/Ao ratio ≥1.04 (p = 0.005).ConclusionsThe PA/Ao ratio is an easily measurable noninvasive indicator that can predict RVF and 1-year mortality after LVAD implantation.Copyright © 2023. Published by Elsevier Inc.

17 keywords...

hide…