Intersection of Pulmonary Hypertension and Right Ventricular Dysfunction in Patients on Left Ventricular Assist Device Support: Is There a Role for Pulmonary Vasodilators?

Christopher T. Sparrow, Shane J. LaRue, Joel D. Schilling

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients. Although pulmonary vasodilators are commonly used for the treatment of pulmonary hypertension and RV dysfunction in LVADs, the benefits of this practice remain unclear. The purpose of this review is to highlight the current challenges in managing pulmonary vascular disease and RV dysfunction in patients with heart failure on LVAD support.

Original languageEnglish
Pages (from-to)e004255
JournalCirculation. Heart failure
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • heart failure
  • heart-assist devices
  • humans
  • hypertension, pulmonary
  • quality of life

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