Skip to main content
  • Letter to the Editor
  • Open access
  • Published:

Detailed mechanism and impact of new-onset late right heart failure during LVAD support

Abstract

Not applicable.

Peer Review reports

To the editor,

Left ventricular assist device (LVAD) unloads the left ventricle and increases cardiac output, whereas LVAD might not be beneficial or rather sometimes harmful for the right heart. New-onset late right heart failure is receiving great concern as unsolved comorbidity thus far. Wagner and colleagues demonstrated that preoperative right heart failure enhanced the risk of early right heart failure post-LVAD and persistent late right heart failure, but not the risk of new-onset late right heart failure [1]. Their findings let us hypothesizing different etiology between early and late right heart failures. Several concerns should more enhance the implication of their findings.

Their concept of “new-onset late right heart failure” would be almost similar to “late-onset right ventricular failure” that we proposed in 2014 [2]. I completely agree with them that a new onset late right heart failure would have a unique etiology, which cannot be predicted simply by the existence of preoperative right heart failure. Instead, as we hypothesized, considerable shrinkage of the left ventricle and associated positive remodeling of the right ventricle during LVAD supports might be a mechanism of late right heart failure [2]. Did any patients have preoperative small left ventricle or etiology of hypertrophic cardiomyopathy? How do the authors hypothesize the mechanism of late right heart failure?

Our team recently demonstrated that right heart failure was associated with hemocompatibility-related adverse events [3]. In their study, late right heart failure was associated with higher mortality. Do the authors have data on causes of death in their study? Such data would more clarify the clinical impact of late right heart failure during LVAD supports.

Availability of data and materials

No data.

Abbreviations

LVAD:

Left ventricular assist device

References

  1. Wagner T, Bernhardt AM, Magnussen C, Reichenspurner H, Blankenberg S, Grahn H. Right heart failure before LVAD implantation predicts right heart failure after LVAD implantation - is it that easy? J Cardiothorac Surg. 2020;15:113.

    Article  Google Scholar 

  2. Imamura T, Kinugawa K, Kato N, Muraoka H, Fujino T, Inaba T, Maki H, Kinoshita O, Hatano M, Kyo S, Ono M. Late-onset right ventricular failure in patients with preoperative small left ventricle after implantation of continuous flow left ventricular assist device. Circ J. 2014;78:625–33.

    Article  CAS  Google Scholar 

  3. Imamura T, Nitta D, Fujino T, Smith B, Kalantari S, Nguyen A, Narang N, Holzhauser L, Rodgers D, Song T, Ota T, Jeevanandam V, Kim G, Sayer G, Uriel N. Deep Y-descent in right atrial waveforms following left ventricular assist device implantation. J Card Fail. 2020;26:360–7.

    Article  Google Scholar 

Download references

Acknowledgments

none.

Funding

None.

Author information

Authors and Affiliations

Authors

Contributions

TI, conceptualization and preparation of the draft. The author(s) read and approved the final manuscript

Corresponding author

Correspondence to Teruhiko Imamura.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Imamura, T. Detailed mechanism and impact of new-onset late right heart failure during LVAD support. J Cardiothorac Surg 15, 245 (2020). https://doi.org/10.1186/s13019-020-01300-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s13019-020-01300-1

Keywords