Impact of Elevated Preoperative Blood Urea Nitrogen (BUN) Levels on Outcomes in CF-LVAD Patients

Purpose Patients with advanced heart failure and cardiorenal syndrome can experience significantly elevation in blood urea nitrogen (BUN) levels. We evaluated the impact of preoperative elevated BUN levels on bleeding and survival in patients who underwent continuous flow - left ventricular assist device (CF-LVAD) implantation. Methods We performed a retrospective review of 737 patients who underwent implantation of CF-LVADs from December 1999 through August 2017 at our center. Preoperative hemodynamics, perioperative characteristics, and postoperative outcomes were compared between patients with BUN ≥60 mmol/L and those Results Of the 664 patients included in the study (73 were excluded due to incomplete data), 53 patients had a BUN ≥60 mmol/L (mean: 83±28) and 611 patients had a BUN Conclusion Preoperative elevation in BUN above 60 mmol/L was associated with higher mortality. Additional studies are warranted to determine whether preoperative optimization of the uremia with medical therapy and/or dialysis can impact the increased risk of mortality.