Mechanical Circulatory Support for Right Ventricular Failure
| Autor: | Anjan K. Chakrabarti, John Finley, Navin K. Kapur, Samer S. Najjar, Anand Jagannathan, Nicole M. Orr, Daniel H. Steinberg, David DeNofrio, Vikram Paruchuri, James O. Mudd, Duc Thinh Pham, Michael Tempelhof, Michael S. Kiernan, Duane S. Pinto, Nima Aghili |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Heart Failure
Male Heart transplantation Mean arterial pressure medicine.medical_specialty Myocarditis business.industry medicine.medical_treatment Central venous pressure Middle Aged medicine.disease Blood pressure Ventricular assist device Internal medicine Heart failure medicine Cardiology Humans Female Heart-Assist Devices Myocardial infarction Cardiology and Cardiovascular Medicine business Retrospective Studies |
| Zdroj: | JACC: Heart Failure. 1:127-134 |
| ISSN: | 2213-1779 |
| DOI: | 10.1016/j.jchf.2013.01.007 |
| Popis: | Objectives The aim of this study was to explore the clinical utility of a commercially available centrifugal flow pump as a centrifugal flow-right ventricular support device (CF-RVSD) in patients with right ventricular failure (RVF). Background RVF is associated with high in-hospital mortality. Limited data regarding efficacy of the CF-RVSD for RVF exist. Methods We retrospectively reviewed data from 46 patients receiving a CF-RVSD for RVF from a registry comprising data from 8 tertiary-care hospitals in the United States. CF-RVSD use was recorded in the setting of acute myocardial infarction; myocarditis; chronic left heart failure; after valve surgery, orthotopic heart transplantation, left ventricular assist device surgery, coronary bypass grafting. Devices were implanted via the percutaneous (n = 22) or surgical (n = 24) route. Results No intraprocedural mortality was observed. Mean time from admission to CF-RVSD implantation was 5.7 ± 8.5 days, with a mean of 6,769 ± 789 rotations/min, providing 4.2 ± 1.3 l/min of flow. Mean duration of support was 5.4 ± 5.1 days. Mean arterial pressure (65 ± 12 mm Hg vs. 73 ± 14 mm Hg; p l 0.05), right atrial pressure (21 ± 8 mm Hg vs. 16 ± 7 mm Hg; p = 0.05), pulmonary artery systolic pressure (43 ± 15 mm Hg vs. 33 ± 15 mm Hg; p = 0.01), and cardiac index (1.7 ± 0.7 vs. 2.2 ± 0.6; p = 0.01) were improved within 48 h of CF-RVSD implantation. Total in-hospital mortality was 57% and was lowest in the setting of left ventricular assist device implantation, chronic left heart failure, and acute myocardial infarction. Increased age, biventricular failure, and Thrombolysis In Myocardial Infarction–defined major bleeding were associated with increased in-hospital mortality. Conclusions Use of the CF-RVSD for RVF is clinically feasible and associated with improved hemodynamic status. Observations from the registry of patients who have received this device may support the development of prospective studies that will examine the role of percutaneous circulatory support for RVF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|