Planned Concomitant Left and Right Ventricular Assist Device Insertion to Avoid Long-term Biventricular Mechanical Support: Bridge to Right Ventricular Recovery

  • Michael Salna Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
  • Yasuhiro Shudo Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
  • Jeffrey J Teuteberg Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
  • Dipanjan Banerjee Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
  • Richard V. Ha Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
  • Y. Joseph Woo Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
  • William Hiesinger Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA

Abstract

Introduction: The planned use of a temporary right ventricular assist device (RVAD) at the time of left ventricular assist device (LVAD) implantation may prevent the need for a permanent biventricular assist device (BiVAD). Herein we describe our RVAD weaning protocol that was effectively employed in
4 patients to prevent the need for permanent BiVAD.

Methods: Four patients in refractory cardiogenic shock underwent planned RVAD insertion during LVAD implantation due to severely depressed right ventricular function with dilation preoperatively. A standardized RVAD weaning protocol was employed in these 4 patients in preparation for decannulation.

Results: Temporary RVADs were successfully placed in all 4 patients at the time of LVAD implantation. All patients survived to RVAD decannulation and discharge and were alive at the time of most recent follow-up (range, 528-742 days post–RVAD decannulation).

Conclusion: Planned implantation of a temporary RVAD in high risk patients may avoid the need for biventricular mechanical support in the future.

References

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Published
2018-10-01
Section
Articles