PMC:6640909 / 72490-74257 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6640909","sourcedb":"PMC","sourceid":"6640909","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6640909","text":"8.2 Evidence review\n\nCentrifugal versus axial-flow implantable left ventricular assist devices\nThe currently approved axial-flow and centrifugal LVADs provide safe and effective circulatory support in a population of patients with end-stage HF [138–150].\nCentrifugal LVADs may facilitate implantation and offer options for different surgical approaches and strategies [151–154].\n\nLeft ventricular assist device versus biventricular assist device: impact of right heart function\nA combination of clinical, haemodynamic, echocardiographic and biochemical parameters might be useful to assess right heart function preoperatively and to predict the need for perioperative mechanical RV support (Supplementary Material, Table S3).\nLevosimendan prior to LVAD implantation might be used to reduce the risk of right ventricular failure, although evidence is limited [155, 156].\nEchocardiographic assessment of RV geometry, contractility and valvular function (Supplementary Material, Table S4) prior to VAD implantation can be useful to evaluate the need for RV support [157–161].\nPatients with adequate right heart function who only require LVAD support have better survival rates, lower adverse event rates and superior quality of life than patients requiring BiVAD or TAH support [147, 162–173].\nRV failure requiring RVAD support is the most important risk factor for early death in LVAD recipients [170, 174–178].\nTemporary RVAD support should be considered in all recipients of an implantable LVAD, even in case of low RV failure risk score (RVAD required in 6–28% of LVAD recipients) [147, 178].\nDelayed institution or rescue implantation of RV support further increases the risk of morbidity and mortality compared to early RVAD implantation [147, 168, 169, 171, 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