Machine learning analysis of right heart failure after left ventricular assist device implantation
For decades, left ventricular-assist devices (LVADs) have extended the lives of people whose hearts have grown too weak to effectively pump blood to the body. For upward of 20% of those patients, though, an LVAD implant gives rise to a dreaded complication: Their right ventricle fails, typically within days.
Cardiac specialists think it’s because the right heart cannot accommodate the suddenly resurgent blood flow from the just-installed pump. When right-heart failure is recognized, the patients receive intravenous medications and temporary mechanical support. In some cases, but not all, these emergency interventions improve the right ventricle’s viability.
Knowing beforehand which patients are at a higher risk to develop right-heart failure might enable doctors to reduce that likelihood.
Researchers reported findings this week of a machine-learning analysis of 186 pre-implant patient factors, revealing the 30 most strongly associated with right-heart failure among a population of 19,595 first-time LVAD recipients.
“We had two objectives with this study: to help predict which patients will develop this complication and to find out if there are factors we can optimize to lower the risk of right-heart failure before we implant the LVAD,” said Dr. Song Li, a heart failure cardiologist at the UW Medicine Heart Institute and the paper’s senior author. Lead author is Dr. Arjun Bahl, third-year medical resident.