BACKGROUND: Right ventricular (RV) failure after the insertion of a left ventricular assist device (LVAD) historically results in poor outcomes. Patients requiring temporary RV support after LVAD insertion are a heterogeneous group of patients consisting of those in cardiogenic shock after myocardial infarction, to those with chronic decompensated heart failure. For patients requiring biventricular support, we have used a hybrid system consisting of a HeartMate II LVAD and CentriMag right ventricular assist device (RVAD). The purpose of this study was to determine the 1-year survival in patients requiring isolated LVAD and patients requiring biventricular support. METHODS: All patients who underwent HeartMate II LVAD alone or in conjunction with a temporary CentriMag RVAD were examined from 2006 to 2011. Preoperative demographics, operative outcomes, and survival were analyzed. RESULTS: A total of 139 patients required HeartMate II insertion; 34 (24%) required biventricular support at the time of HeartMate II implantation. The mean duration of biventricular support was 17 ± 11.9 days (range, 6 to 56 days) with 91.8% (n = 31) of RVADs successfully explanted. Survival to hospital discharge was not different between groups (95.2 versus 88.2%; p = 0.2). However, 1-year survival was significantly greater in patients who required isolated HeartMate II LVAD (87% versus 77%; p = 0.03). CONCLUSIONS: Biventricular support using a HeartMate II LVAD and CentriMag RVAD resulted in limited mortality at hospital discharge. However biventricular dysfunction does not have a favorable outcome at 1 year when compared with patients requiring isolated HeartMate II.
BACKGROUND: Right ventricular (RV) failure after the insertion of a left ventricular assist device (LVAD) historically results in poor outcomes. Patients requiring temporary RV support after LVAD insertion are a heterogeneous group of patients consisting of those in cardiogenic shock after myocardial infarction, to those with chronic decompensated heart failure. For patients requiring biventricular support, we have used a hybrid system consisting of a HeartMate II LVAD and CentriMag right ventricular assist device (RVAD). The purpose of this study was to determine the 1-year survival in patients requiring isolated LVAD and patients requiring biventricular support. METHODS: All patients who underwent HeartMate II LVAD alone or in conjunction with a temporary CentriMag RVAD were examined from 2006 to 2011. Preoperative demographics, operative outcomes, and survival were analyzed. RESULTS: A total of 139 patients required HeartMate II insertion; 34 (24%) required biventricular support at the time of HeartMate II implantation. The mean duration of biventricular support was 17 ± 11.9 days (range, 6 to 56 days) with 91.8% (n = 31) of RVADs successfully explanted. Survival to hospital discharge was not different between groups (95.2 versus 88.2%; p = 0.2). However, 1-year survival was significantly greater in patients who required isolated HeartMate II LVAD (87% versus 77%; p = 0.03). CONCLUSIONS: Biventricular support using a HeartMate II LVAD and CentriMag RVAD resulted in limited mortality at hospital discharge. However biventricular dysfunction does not have a favorable outcome at 1 year when compared with patients requiring isolated HeartMate II.
Authors: Deborah D Ascheim; Annetine C Gelijns; Daniel Goldstein; Lemuel A Moye; Nicholas Smedira; Sangjin Lee; Charles T Klodell; Anita Szady; Michael K Parides; Neal O Jeffries; Donna Skerrett; Doris A Taylor; J Eduardo Rame; Carmelo Milano; Joseph G Rogers; Janine Lynch; Todd Dewey; Eric Eichhorn; Benjamin Sun; David Feldman; Robert Simari; Patrick T O'Gara; Wendy C Taddei-Peters; Marissa A Miller; Yoshifumi Naka; Emilia Bagiella; Eric A Rose; Y Joseph Woo Journal: Circulation Date: 2014-03-28 Impact factor: 29.690
Authors: Prateeti Khazanie; Bradley G Hammill; Chetan B Patel; Michael S Kiernan; Lauren B Cooper; Suzanne V Arnold; Timothy J Fendler; John A Spertus; Lesley H Curtis; Adrian F Hernandez Journal: J Card Fail Date: 2016-02-15 Impact factor: 5.712
Authors: Toshinobu Kazui; Phat L Tran; Angela Echeverria; Catherine F Jerman; Jessika Iwanski; Samuel S Kim; Richard G Smith; Zain I Khalpey Journal: J Cardiothorac Surg Date: 2016-08-04 Impact factor: 1.637