Akin et al reported factors associated with early mortality following placement of a left ventricular assist device (LVAD). These can help to identify a patient who may require more aggressive management or an alternative management strategy. The authors are from Erasmus MC University in Rotterdam.

Patient selection: left ventricular assist device (LVAD)


Outcome: early mortality (within first 90 days)


Most common causes of death:

(1) multi-organ failure

(2) sepsis

(3) cardiopulmonary failure



(1) older age

(2) INTERMACS profile 1, 2 or 3 (sicker)

(3) preoperative anemia

(4) impaired renal function

(5) impaired liver function

(6) impaired right ventricular function (high RA/PCWP, other)

(7) delayed placement of the LVAD

(8) nosocomial infection


The patient may benefit from:

(1) early or short-term mechanical circulatory support

(2) aggressive and optimization of right-sided filling pressures

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