Right-Sided Cardiac Failure After Destination-Therapy-Left Ventricular Assist Device: Where Do We Go from Here?

Previous investigations have examined predictors and consequences of postoperative RHF in the LVAD population at large, however, outcomes specific to DT-LVAD recipients are less well established.2,4 Meanwhile, the proportion of DT-LVADs has been steadily increasing in response to shifting incentives following the revised 2018 Organ Procurement and Transplantation Network heart allocation criteria.5 Given that treatment options for refractory RHF are restricted to concurrent temporary RVAD, chronic inotrope infusion with LVAD, or palliation, understanding survival and other key clinical outcomes within the DT-LVAD population in real-world settings is a crucial area of investigation. After multivariable adjustment, RVAD requirement was associated with increased mortality at 1 year (hazard ratio 5.6, 95% confidence interval 1.9 to 16.0, p