Reply to Gokalp et al.

Abstract

We thank you for your comments regarding our manuscript 'Risk factors for the development of right ventricular failure after left ventricular assist device implantation: a single-centre retrospective with focus on deformation imaging' [1]. We were pleased that you were interested in our article and appreciate the time and effort you spent writing your letter [2]. Indeed, the prediction of postoperative right ventricular performance in left ventricular assist device (LVAD) implantation remains a difficult task, particularly if the right ventricular function is marginal preoperatively. We appreciate the multiple points made by Gokalp et al. However, the scope of our investigation was whether deformation imaging adds to the preoperative assessment of right ventricular function and thus has a predictive value. Therefore, we did not provide further details about the treatment options for right ventricular failure (RVF) [1]. Regarding your question about extracorporeal mechanical support for RVF, only 2 patients with severe RVF (as defined by INTERMACS) required temporary right-sided mechanical support. We actually used the Levitronix CentriMag (Thoratec Corporation, Pleasanton, CA, USA) fitted with an oxygenator in 1 of the 13 RVF cases, as you had suggested. The other case of severe RVF needing mechanical support was temporarily fitted with a Cardiohelp system (Maquet, Rastatt, Germany) that provided right-sided extracorporeal membrane oxygenation.