PLACE: Multicenter Study for Right Ventricular Failure on Mechanical Cardiocirculatory Supports

ASAIO Journal, vol. 71, pp. 290–299

Abstract

Isolated acute right ventricular failure (aRVF) is associated with poor prognosis in different scenarios. In severe conditions, temporary mechanical cardiocirculatory support (tMCS) is required. PLACE is an international, retrospective, multicenter registry including 17 centers that investigated patients affected by isolated aRVF and treated with various types of tMCS from January 2000 to December 2020. The registry included 644 (69.6% males, mean age: 55 years) patients. The most frequent etiologies were post-left ventricular assist device implantation (LVAD) and postcardiotomy shock. These patients received mostly mechanical circulatory support (MCS) and veno-arterial extracorporeal membrane oxygenation. Mean tMCS duration was 9 days, weaning was achieved in 70.5% of the patients, and the major cause of death on support was multiorgan failure (50.5%). The mortality rate was 45 and 48.4% in-hospital and at 3 month follow-up, respectively. Multivariable logistic regression analysis identified age, aRVF due to acute pulmonary hypertension, bilirubin level, and oliguria or anuria at tMCS implantation as risk factors for in-hospital mortality. Conversely, aRVF after LVAD was found to be associated with a lower risk of early mortality. In-hospital and 3 months mortality occurred in less than half of the aRVF-supported subjects. Furthermore, several preimplant aspects such as age, organ function, and type of tMCS are independently associated with in-hospital and 3 month mortality.

Authors 19

1. Valeria Lo Coco

   Maastricht University Medical Centre

   Affiliation as printed

   Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands

2. Michele Di Mauro corresponding

   Maastricht University Medical Centre

   Affiliation as printed

   Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands

3. Antonio Loforte

   IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola · University of Turin

   Affiliation as printed

   Department of Cardiac Surgery, Sant’ Orsola University Hospital, Bologna, Italy

   Department of Surgical Sciences, University of Turin, Turin, Italy

4. Thomas Fux

   Karolinska University Hospital · Karolinska Institutet

   Affiliation as printed

   Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden

   Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden

5. Dominik Wiedemann

   Medical University of Vienna

   Affiliation as printed

   Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria

6. Tom Verbelen

   Universitair Ziekenhuis Leuven

   Affiliation as printed

   Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium

7. Lars Mikael Broman corresponding

   Karolinska University Hospital

   Affiliation as printed

   Extracorporeal Membrane Oxygenation Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden

8. Jamila Kremer

   University Hospital Heidelberg

   Affiliation as printed

   Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany

9. Mattéo Pozzi

   Hôpital Louis Pradel

   Affiliation as printed

   Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Lyon, France

10. Koji Takeda

    Columbia University Irving Medical Center

    Affiliation as printed

    Department of Cardiac Surgery, Columbia University Irving Medical Center, New York, New York

11. Udo Boeken

    Düsseldorf University Hospital

    Affiliation as printed

    Department of Cardiac Surgery, University Hospital Düsseldorf, Düsseldorf, Germany

12. Yih‐Sharng Chen

    National Taiwan University Hospital

    Affiliation as printed

    Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei City, Taiwan

13. Paolo Masiello

    AOU San Giovanni di Dio e Ruggi d'Aragona

    Affiliation as printed

    Emergency Cardiac Surgery—Cardio-Thoracic-Vascular Surgery Department, University Hospital San Giovanni di Dio e Ruggi D’Aragona, Salerno, Italy

14. Dominik J. Vogel corresponding

    National Health Service · Guy's and St Thomas' NHS Foundation Trust

    Affiliation as printed

    Department of Intensive Care Medicine, Guy’s and St Thomas’ National Health Service Foundation Trust, London, UK

15. Jacinta J. Maas Aachen Department of Intensive Care

    Leiden University Medical Center

    Affiliation as printed

    Department of Intensive Care, Leiden University Medical Center, Leiden, the Netherlands

16. Andrea Ballotta

    Centro Cardiologico Monzino

    Affiliation as printed

    Department of Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico Centro Cardiologico Monzino, Milano, Italy

17. Federico Pappalardo

    Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo

    Affiliation as printed

    Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy

18. Kasia Hryniewicz
    Affiliation as printed

    Department of Cardiology, Minneapolis Heart Institute, Minneapolis, Minnesota

    Department of Cardiology, Minneapolis Heart Institute, Minneapolis, Minnesota; and

19. Roberto Lorusso corresponding

    Maastricht University Medical Centre

    Affiliation as printed

    Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands

    Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands