Akin et al reported factors associated with early mortality following placement of a left ventricular assist device (LVAD). These can help to identify a patient who may require more aggressive management or an alternative management strategy. The authors are from Erasmus MC University in Rotterdam.
Patient selection: left ventricular assist device (LVAD)
Outcome: early mortality (within first 90 days)
Most common causes of death:
(1) multi-organ failure
(2) sepsis
(3) cardiopulmonary failure
Predictors:
(1) older age
(2) INTERMACS profile 1, 2 or 3 (sicker)
(3) preoperative anemia
(4) impaired renal function
(5) impaired liver function
(6) impaired right ventricular function (high RA/PCWP, other)
(7) delayed placement of the LVAD
(8) nosocomial infection
The patient may benefit from:
(1) early or short-term mechanical circulatory support
(2) aggressive and optimization of right-sided filling pressures
