IMR Press / RCM / Volume 23 / Issue 9 / DOI: 10.31083/j.rcm2309308
Open Access Review
Management of Pulmonary Hypertension in Patients on Left Ventricular Assist Device Support
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1 Center for Advanced Heart and Lung Diseases, Baylor University Medical Center, Dallas, TX 75246, USA
2 Heart and Vascular Institute, University of Pittsburgh Medical Center, Harrisburg, PA 17101, USA
*Correspondence: shelley.hall@bswhealth.org (Shelley Hall)
Academic Editor: Jerome L. Fleg
Rev. Cardiovasc. Med. 2022, 23(9), 308; https://doi.org/10.31083/j.rcm2309308
Submitted: 31 March 2022 | Revised: 6 July 2022 | Accepted: 18 July 2022 | Published: 13 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Left ventricular assist devices (LVADs) are increasingly utilized for patients with end-stage heart failure (HF). Pulmonary hypertension (PH) is highly prevalent in this patient population mainly due to prolonged left ventricular (LV) failure and chronically elevated filling pressures. The effect of LVADs on pulmonary circulation and right ventricular (RV) function has recently become an area of great attention in literature. PH can lead to post-LVAD right ventricular failure (RVF) that confers a high risk of morbidity and mortality. Multiple pulmonary vasodilators, that are primarily used for the treatment of pulmonary arterial hypertension (PAH), have been studied for the treatment of PH after LVAD implantation, and some of them have shown promising results. This review aims to investigate the treatment options for PH in patients on LVADs, as well as to give an overview about the pathophysiology of PH and RVF in these patients.

Keywords
heart failure
pulmonary hypertension
pulmonary vasodilators
right ventricular failure
left ventricular assist device
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