Technique of Implantation and Experience with Temporary Mechanical Cardiac Support in Right Ventricular Failure
Authors:
I. Netuka; J. Malý; O. Szárszoi; H. Říha 1; D. Turek; M. Urban; I. Skalský; T. Kotulák 1; Z. Dorazilová 2; J. Pirk
Authors place of work:
Klinika kardiovaskulární chirurgie, Institut klinické a experimentální medicíny, Praha a Centrum výzkumu chorob srdce a cév 4, Praha, Česká republika
; Klinika anesteziologie a resuscitace, Institut klinické a experimentální medicíny, Praha a Centrum výzkumu chorob srdce a cév 4, Praha, Česká republika
1; Klinika kardiologie, Institut klinické a experimentální medicíny, Praha a Centrum výzkumu chorob srdce a cév 4, Praha, Česká republika
2
Published in the journal:
Rozhl. Chir., 2011, roč. 90, č. 2, s. 88-94.
Category:
Monothematic special - Original
Summary
Aim:
Severe right heart failure remains unfrequent but fatal complication of cardiac surgical procedures. Implantation of temporary right ventricular assist device may be life-saving procedure in various situations of right heart failure as: heart transplantation, LVAD therapy and post-cardiotomy failure. The aim of the study is an introduction of the implantation technique and retrospective review of current experience with the method.
Material and Methods:
Since January 2007 isolated right ventricular assist device Levitronix CentriMag has been implanted in 16 patients. Patients were divided into 3 groups: post transplantation (post-Tx), post LVAD implantation (post-LVAD) and other cardiac procedures (OCP). Success rate of weaning from RVAD, 30-days mortality and major complications has been assessed.
Outcomes:
Distribution of implants in groups was: post-Tx 5 pts (31%), post-LVAD 6 pts (38%) and 5 in OCP group (31%). The mean support time was 12 days. Off-pump implantation was achieved in 9 pts. The device was successfully weaned in 13 (81%) patients. 30-days mortality occurred in 1 case only.
Conclusion:
Presented outcomes are encouraging for broader acceptance of the therapy. Excellent success rate has been reached in post-Tx and post-LVAD. This study emphasises decesive role of proactive approach in early indication of RVAD implantation for achieving satisfactory results.
Key words:
right heart failure – ventricular assist device – heart transplantation – right ventricle – implantation
Zdroje
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