Impact of Preoperative Right Ventricular Function on Acute Renal Failure Development in Patients With Ventricular Assist Devices

Background Acute kidney injury (AKI) and acute renal failure contribute significantly to the high mortality and morbidity seen in patients with left ventricular assist devices (LVADs). The role of preoperative right ventricular function in the onset of acute renal failure remains an area of active investigation. This study aims to explore the correlation between preoperative right ventricular function and the development of AKI in patients undergoing LVAD implantation. Methods The demographic characteristics, comorbidities, and preoperative and postoperative data of 61 patients who underwent LVAD implantation between April 2012 and December 2021 were carefully documented. Transthoracic echocardiography was used to assess right ventricular function, with tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (FAC) serving as key evaluation parameters. TAPSE values of ≥17 mm and FAC of ≥35% were considered indicative of normal right ventricular function. Based on these measurements, the study analyzed the association between preoperative right ventricular function and the incidence of postoperative AKI. Results When patients were grouped based on TAPSE values, significant differences emerged in ICU stay duration, hospital stay length, AKI development, and the need for renal replacement therapy post-AKI. Elevated preoperative serum creatinine levels (p = 0.01), older age (p = 0.02), higher body surface area (p = 0.024), and lower TAPSE values (p = 0.02) were identified as risk factors for postoperative AKI. However, no significant correlation was found between preoperative FAC values and AKI incidence in LVAD-implanted patients. Conclusions Preoperative TAPSE appears to be a more reliable predictor of postoperative renal dysfunction than FAC.