Thomas R Keeble1, Grigoris V Karamasis2, Martin T Rothman3, Sven-Erik Ricksten4, Markus Ferrari5, Roger Hullin6, Fredrik Scherstén7, Oyvind Reitan8, Sebastian T Kirking9, John G F Cleland10, Elliot J Smith3. 1. Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK; Anglia Ruskin School of Medicine, Chelmsford, UK. Electronic address: thomas.keeble@btuh.nhs.uk. 2. Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK; Anglia Ruskin School of Medicine, Chelmsford, UK. 3. Barts Heart Centre, Barts Health NHS Trust, London, UK. 4. Department of Anesthesiology and Intensive Care, University of Göteborg, Göteborg, Sweden. 5. Department of Internal Medicine I, Friedrich-Schiller University, Jena, Germany; HSK, Clinic of Internal Medicine I, Helios-Kliniken, Wiesbaden, Germany. 6. Department of Cardiology, CHUV, Lausanne, Switzerland. 7. Department of Cardiology, Skåne University Hospital, Lund, Sweden. 8. Department of Cardiology, Skåne University Hospital, Lund, Sweden; CardioBridge GmbH, Hechingen, Germany. 9. CardioBridge GmbH, Hechingen, Germany. 10. Robertson Centre for Biostatistics and Clinical Trials, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK; National Heart & Lung Institute, Royal Brompton & Harefield Hospitals NHS Trust, Imperial College, London, UK.
Abstract
BACKGROUND: Worsening heart failure complicated by congestion, hypotension, and renal dysfunction is difficult to manage, increasingly common and predicts a poor outcome. Novel therapies are required to facilitate diuresis and implementation of disease-modifying interventions in preparation for hospital discharge. Accordingly, we investigated the haemodynamic and renal effects of the Reitan Catheter Pump (RCP) percutaneous support device in patients admitted with decompensated heart failure (DHF). METHODS: This was a prospective observational study of 20 patients admitted with DHF, ejection fraction < 30%, and Cardiac index (CI) < 2.1 L/min/m2 in need of inotropic/mechanical support. RESULTS: Patients underwent RCP support for a mean of 18.3 (±6.3) hours. The RCP increased CI from 1.84 L/min/m2 (±0.27), to 2.41 L/min/m2 (±0.45, p = 0.04), increased urine output (71 mL/h (±65) to 227 ml/h (±179) (p = 0.006) with a concomitant reduction in serum creatinine (188 μmol/L (±87) to 161 μmol/L (±78) (p = 0.0007). There were no clinically significant haemolysis, vascular injury, or thrombo-embolic complications. CONCLUSIONS: For patients admitted with DHF, the RCP improves cardiac index, diuresis and renal function without causing important complications.
BACKGROUND: Worsening heart failure complicated by congestion, hypotension, and renal dysfunction is difficult to manage, increasingly common and predicts a poor outcome. Novel therapies are required to facilitate diuresis and implementation of disease-modifying interventions in preparation for hospital discharge. Accordingly, we investigated the haemodynamic and renal effects of the Reitan Catheter Pump (RCP) percutaneous support device in patients admitted with decompensated heart failure (DHF). METHODS: This was a prospective observational study of 20 patients admitted with DHF, ejection fraction < 30%, and Cardiac index (CI) < 2.1 L/min/m2 in need of inotropic/mechanical support. RESULTS:Patients underwent RCP support for a mean of 18.3 (±6.3) hours. The RCP increased CI from 1.84 L/min/m2 (±0.27), to 2.41 L/min/m2 (±0.45, p = 0.04), increased urine output (71 mL/h (±65) to 227 ml/h (±179) (p = 0.006) with a concomitant reduction in serum creatinine (188 μmol/L (±87) to 161 μmol/L (±78) (p = 0.0007). There were no clinically significant haemolysis, vascular injury, or thrombo-embolic complications. CONCLUSIONS: For patients admitted with DHF, the RCP improves cardiac index, diuresis and renal function without causing important complications.
Authors: Navin K Kapur; Richard H Karas; Sarah Newman; Lena Jorde; Tina Chabrashvili; Shiva Annamalai; Michele Esposito; Carey D Kimmelstiel; Tim Lenihan; Daniel Burkhoff Journal: Catheter Cardiovasc Interv Date: 2019-05-21 Impact factor: 2.692