Preoperative Pulmonary Artery-to-Aorta Diameter Ratio as a Predictor of Postoperative Severe Right Ventricular Failure and 1-Year Mortality After Left Ventricular Assist Device Implantation
Authors' conclusion
The PA/Ao ratio is an easily measurable noninvasive indicator that can predict RVF and 1-year mortality after LVAD implantation.
Study context
- Population
- Adults (≥18 years) receiving a durable left ventricular assist device (LVAD), with chest CT and right and left heart catheterization within 30 days before the LVAD, single quaternary-care academic center, March 2013–July 2019
- Participants
- 176 adults
- Exposure
- Severe right ventricular failure (RVF) vs no severe RVF; PA/Ao ratio ≥1.04 vs <1.04
- Outcome
- PA diameter and PA/Ao ratio in severe RVF
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Median PA diameter significantly greater in the severe RVF group
- p = 0.001
- Median PA/Ao ratio significantly greater in the severe RVF group
- p < 0.001
Observational data: associations, not effects.
Further findings
Prediction of mortality (ROC analysis)
- AUC of PA/Ao for mortality
- 0.725
- AUC of RVF for mortality
- 0.933
PA/Ao ratio cutoff (logistic regression-predicted probability)
- PA/Ao ratio cutoff point
- 1.04
- P value
- P < 0.001
Survival probability
- Survival significantly worse with PA/Ao ratio ≥1.04
- P = 0.005
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Preoperative Pulmonary Artery-to-Aorta Diameter Ratio as a Predictor of Postoperative Severe Right Ventricular Failure and 1-Year Mortality After Left Ventricular Assist Device Implantation. J Cardiothorac Vasc Anesth. Published 17 March 2023. doi:10.
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