Table 4.
Post-LVAD Post-Chest Closure Intraoperative Echocardiographic and Hemodynamic Predictors of Severe RVF
| Variables Post-CPB | Nonsevere RVF (n = 57) | Severe RVF (n = 28) | P Value |
| Echocardiographic variables | |||
| RVEDA (cm2) | 24.5 ±48.1 | 28.00 ± 8.72 | .07 |
| RVESA (cm2) | 18.5 ±87.9 | 22.56 ± 8.40 | .034 |
| RVFAC | 26.0 6.12.6 | 20.19 ± 10.84 | .041 |
| ESRAA (cm2) | 19.7 ±97.2 | 23.05 ± 6.75 | 0.045 |
| TAPSE (cm) | 1.1 ±.0.3 | 0.94 ± 0.23 | .008 |
| TVR grade: median (interquartile range) | 1(1, 2) | 2 (1, 2) | .16a |
| MVR grade: median (interquartile range) | 1 (1, 2) | 1 (1, 2) | .25a |
| RAdMinor (cm) | 4.6 ± 1.0 | 5.1 ± 1.0 | .09 |
| RAdMajor (cm) | 4.9 ± 1.0 | 5.4 ± 0.9 | .026 |
| RVEDD (cm) | 4.3 ± 0.9 | 4.6 ± 0.9 | .10 |
| LVEDD (cm) | 5.4 ± 1.2 | 5.4 ± 1.2 | .97 |
| RV/LV diameter ratio | 0.8 ± 0.2 | 0.9 ± 0.2 | .23 |
| Variables After Chest Closure | Nonsevere RVF | Severe RVF | P Value |
| Hemodynamic variables | |||
| PASP (mm Hg) | 37.5 ± 9.3 | 38.8 ± 9.2 | .54 |
| PADP (mm Hg) | 20.0 ± 6.0 | 23.8 ± 5.1 | .007 |
| PA pulse pressure (mm Hg) | 17.5 ± 5.7 | 15.0 ± 6.0 | .08 |
| CVP (mm Hg) | 12.9 ± 4.8 | 18.1 ± 8.6 | .0008 |
| PAPi (mm Hg) | 1.5 ± 0.8 | 0.9 ± 0.5 | .0008 |
| Univariate Logistic Regression Results for Echocardiographie and Hemodynamic Variables of Interest | |||
| Measurement (n = 81) | Odds Ratio (95% CI) | P Value | AUC (95% CI) |
| Post-CPB TAPSE | 0.08 (0.01, 0.51) | .008 | 0.68 (0.56–0.80) |
| Post-CPB RAdMajor | 1.70 (1.05, 2.76) | .03 | 0.66 (0.54–0.78) |
| Post-CPB RVFAC | 0.99 (0.94, 1.03) | .6 | 0.53 (0.40–0.67) |
| RVFRS | 1.21 (0.91, 1.61) | .2 | 0.58 (0.48–0.68) |
| Post-chest closure PAPi | 0.20 (0.07, 0.55) | .002 | 0.75 (0.64–0.86) |
| Post-chest closure CVP | 1.21 (1.08, 1.36) | .001 | 0.75 (0.64–0.86) |
All data are presented as mean ± standard deviation or N (%) except where noted. Comparisons are made with 2-tailed t test and χ2 tests.
Abbreviations: AUC, area under the curve; CI, confidence interval; CPB, cardiopulmonary bypass; CVP, central venous pressure; ESRAA, end-systolic right atrial area; LVAD, left ventricular assist device; LVEDD, left ventricle end-diastolic diameter; MR, mitral regurgitation; PA, pulmonary artery; PADP pulmonary artery diastolic pressure; PAPi, pulmonary artery pulsatility index; PASP, pulmonary artery systolic pressure; RAdMajor, right atrial diameter major; RAdMinor, right atrial diameter minor; RVEDA, right ventricular end-diastolic area; RVEDD, right ventricle end-diastolic diameter; RVFRS, right ventricular failure risk score; RVESA, right ventricular end-systolic area; RVF, right ventricular failure; RVFAC, right ventricle fractional area of change; RV/LV, right ventricle/left ventricle; TAPSE, tricuspid annular plane systolic excursion; TR, tricuspid regurgitation.
Mann-Whitney U test.