Right ventricular recovery induced by temporary right ventricular assist device support

Stepanenko, Alexander (1)

Deutsches Herzzentrum Berlin (1)

BACKGROUND: Potential for right ventricular (RV) myocardial recovery induced by mechanical assistance and exact guidelines for right ventricular assist device (RVAD) weaning are still challenging.

METHODS: Between 01/2008 and 10/2013 a total of 584 LVAD were implanted. Of them 69 patients required implantation of a temporary RVAD (Thoratec® CentriMag®) for treatment of RV failure after the initiation of support. RVAD patients were retrospectively evaluated.

RESULTS: Thirty-three patients on RVAD reached candidacy for weaning after a median of 6 days (range 1-36) of full RVAD support. Four of them were non-weanable and were bridged to heart transplantation (n=1) or implantable RVAD (n=3). In 2 patients weaning was interrupted due to onset of sepsis and late tamponade (both died on RVAD after 25 and 39 days). RVAD-weaned patients (n=27) required a median support duration of 20 days (range 3-65). At last follow-up LVAD outpatients (n=19, 13.2±5.3 months, cumulative support 25 patient/years) showed stable right ventricular function.

CONCLUSION: The outcomes of patients who require temporary RVAD after LVAD insertion are still unsatisfactory.

However, once patients in our study had reached weaning candidacy, the procedural success rate rose to 90% with RV myocardial recovery allowing weaning of over 80% and discharge home in 57%.

COMUNICACIONES ORALES. ORAL – 10

XIII CONGRESO DE LA SOCIEDAD ANDALUZA DE CIRUGÍA CARDIOVASCULAR (SACCV). Granada, 24, 25 y 26 de Septiembre de 2015