+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Right ventricular assist device with membrane oxygenator support for right ventricular failure following implantable left ventricular assist device placement



Right ventricular assist device with membrane oxygenator support for right ventricular failure following implantable left ventricular assist device placement



European Journal of Cardio-Thoracic Surgery 49(1): 73-77



Cardiogenic shock from refractory right ventricular (RV) failure during left ventricular assist device placement is associated with high morbidity and mortality. The addition of extracorporeal membrane oxygenation to RV mechanical assistance may help RV recovery and lead to improved outcomes. We retrospectively reviewed all implanted continuous-flow left ventricular assist devices from April 2009 to June 2013. RV mechanical support was utilized for RV failure defined as haemodynamic instability despite vasopressors, pulmonary vascular dilators and inotropic therapy. RV assist devices were utilized with and without in-line membrane oxygenation. During the study period, 267 continuous-flow left ventricular assist devices were implanted. RV mechanical support was utilized in 27 (10%) patients; 12 (46%) had the addition of in-line extracorporeal membrane oxygenation. The mean age of patients with a right ventricular assist device with membrane oxygenation was lower than that in patients with a right ventricular assist device alone (45.6 ± 15.9 vs 64.6 ± 6.5, P = 0.001). Support was weaned in 66% (10 of 15) of patients with right ventricular assist device (RVAD) alone vs 83% (10 of 12) of those with RVAD with membrane oxygenation (P = 0.42). The RVAD was removed after 10.4 ± 9.4 vs 5 ± 2.99 days for patients with a RVAD with membrane oxygenation (P = 0.1). Patients with RVAD with membrane oxygenation had a 30-day mortality rate of 8 vs 47% for those with RVAD alone (P = 0.04). The survival rate after discharge was 86, 63 and 54% at 3, 6 and 12 months for both groups combined. Patients with a RVAD with membrane oxygenation support for acute RV failure after continuous-flow left ventricular assist device implantation had a lower 30-day mortality than those with a RVAD alone. Patients who survive to discharge have a reasonable 1-year survival. Combining membrane oxygenation with RVAD support appears to offer a short-term survival benefit in patients with RV failure after continuous-flow left ventricular assist device implantation.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058775175

Download citation: RISBibTeXText

PMID: 25877948

DOI: 10.1093/ejcts/ezv116


Related references

Liberal Right Ventricular Assist Device Extracorporeal Membrane Oxygenation Support for Right Ventricular Failure after Implantable Left Ventricular Assist Device Placement. Asaio Journal 64(6): 741-747, 2017

Outcome of unplanned right ventricular assist device support for severe right heart failure after implantable left ventricular assist device insertion. Journal of Heart and Lung Transplantation 33(2): 141-148, 2014

Simultaneous temporary CentriMag right ventricular assist device placement in HeartMate II left ventricular assist system recipients at high risk of right ventricular failure. Interactive Cardiovascular and Thoracic Surgery 10(6): 847-850, 2010

Right ventricular failure after left ventricular assist device implantation with concomitant pulmonary embolectomy needing right ventricular assist device support in a patient with terminal heart failure and asymptomatic pulmonary thrombus. Interactive Cardiovascular and Thoracic Surgery 10(1): 154-155, 2010

Temporary extracorporeal left ventricular assist device support for implantable left ventricular assist device replacement cases. Journal of Thoracic and Cardiovascular Surgery 147(4): E46-E48, 2014

Right ventricular failure after left ventricular assist device implantation: the need for an implantable right ventricular assist device. Artificial Organs 29(5): 369-377, 2005

Results of Unplanned Right Ventricular Assist Device for Severe Right Ventricular Failure after Continuous Flow Left Ventricular Assist Device Insertion. The Journal of Heart and Lung Transplantation 37(4): S370-S371, 2018

Advanced Heart Failure Treated with Continuous-Flow Left Ventricular Assist Device; Intrapericardial Left Ventricular Assist Device for Advanced Heart Failure; Increase in Left Ventricular Assist Device Thrombosis. New England Journal of Medicine 379(7): 697-697, 2018

A Novel Technique of Temporary Right Ventricular Assist Device (RVAD) Placement During Durable Left Ventricular Assist Device (LVAD) Implant to Allow Early Ambulation and Bedside Percutaneous Removal. Journal of Heart and Lung Transplantation 36(4): S28-S29, 2017

Application of Extracorporeal Membrane Oxygenator (ECMO) Support in Adult Patients with Cardiogenic Shock as a Bridge to Implantable Left Ventricular Assist Device (LVAD). Journal of Heart and Lung Transplantation 35(4): S335-S336, 2016

Outcomes of Minimally Invasive Temporary Right Ventricular Assist Device Support for Acute Right Ventricular Failure During Minimally Invasive Left Ventricular Assist Device Implantation. Asaio Journal 63(5): 546-550, 2017

Post-cardiac transplant survival after support with a continuous-flow left ventricular assist device: impact of duration of left ventricular assist device support and other variables. Journal of Thoracic and Cardiovascular Surgery 140(1): 174-181, 2010

Extracorporeal membrane oxygenation support for right ventricular failure after left ventricular assist device implantation. European Journal of Cardio-Thoracic Surgery 53(3): 590-595, 2018

Postcardiac transplant survival after support with a continuous-flow left ventricular assist device: Impact of duration of left ventricular assist device support and other variables. Yearbook of Cardiology 2011: 171-172, 2011

Transesophageal echocardiography diagnosis of extracardiac left ventricular assist device inflow cannula obstruction in a patient with thoratec intracorporeal ventricular assist device biventricular support. Journal of the American Society of Echocardiography 21(6): 777.E5, 2008