The relationship between preoperative pulmonary vascular resistance and prognosis in patients undergoing left ventricular assist device implantation: a single-center report
10.3760/cma.j.cn112434-20241203-00300
- VernacularTitle:术前肺阻力与左心辅助装置植入患者预后的关系：单中心报道
- Author:
Junjiang LIU
1
;
Dingqian LIU
;
Guangwei HAO
;
Zhe LUO
;
Kefang GUO
;
Lili DONG
;
Xin LI
;
Guowei TU
;
Chunsheng WANG
;
Xiaoning SUN
Author Information
1. 复旦大学附属中山医院心外科，上海 200032
- Publication Type:Journal Article
- Keywords:
Heart failure;
Left ventricular assist device;
Pulmonary hypertension;
Pulmonary vascular resistance
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(9):556-560
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.
