A novel approach to percutaneous right-ventricular mechanical support

Hiroo Takayama, Yoshifumi Naka, Susheel K. Kodali, Julie A. Vincent, Linda J. Addonizio, Ulrich P. Jorde, Mathew R. Willia

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Objective: We report our initial experience with our newly developed percutaneous right-ventricular assist device (VAD) with CentriMag (perc CM-RVAD). Methods: A flexible outflow cannula placed from the right internal jugular vein to the pulmonary artery and an inflow cannula placed from the femoral vein to the right atrium constituted the perc CM-RVAD. When needed, biventricular support was provided with left VAD (LVAD), either with a percutaneous LVAD placed through axillary or femoral artery access or with a fully implantable LVAD. Results: Between January 2009 and June 2010, all of the attempted patients successfully received perc CM-RVAD (n = 8). Mean blood pressure, heartrate, and central venous pressure showed a trend toward improvement after the perc CM-RVAD, with less inotrope/ vasopressor requirement. Mixed venous oxygen saturation (SvO2) increased significantly from 64 ± 20 Torr to 78 ± 6 Torr (P < 0.01). The percutaneous VADs were explanted after myocardial recovery in seven patients; however, in three of these, perc CM-RVAD was used as a temporary bridge to other devices. One patient was bridged to a surgical biventricular assist device (BiVAD)and transferred back to the referring hospital on support. One death occurred due to multiple-organfailure 8 days after explantation of the RVAD with recovery. Conclusions: Perc CM-RVAD was feasible and provided hemodynamic improvement.

Original languageEnglish (US)
Pages (from-to)423-426
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Volume41
Issue number2
DOIs
StatePublished - 2012
Externally publishedYes

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Heart-Assist Devices
Axillary Artery
Equipment and Supplies
Central Venous Pressure
Femoral Vein
Jugular Veins
Femoral Artery
Heart Atria
Pulmonary Artery
Hemodynamics
Oxygen
Blood Pressure
Cannula

Keywords

  • CentriMag
  • Percutaneous
  • Ventricular assist device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Takayama, H., Naka, Y., Kodali, S. K., Vincent, J. A., Addonizio, L. J., Jorde, U. P., & Willia, M. R. (2012). A novel approach to percutaneous right-ventricular mechanical support. European Journal of Cardio-thoracic Surgery, 41(2), 423-426. https://doi.org/10.1016/j.ejcts.2011.05.041

A novel approach to percutaneous right-ventricular mechanical support. / Takayama, Hiroo; Naka, Yoshifumi; Kodali, Susheel K.; Vincent, Julie A.; Addonizio, Linda J.; Jorde, Ulrich P.; Willia, Mathew R.

In: European Journal of Cardio-thoracic Surgery, Vol. 41, No. 2, 2012, p. 423-426.

Research output: Contribution to journalArticle

Takayama, H, Naka, Y, Kodali, SK, Vincent, JA, Addonizio, LJ, Jorde, UP & Willia, MR 2012, 'A novel approach to percutaneous right-ventricular mechanical support', European Journal of Cardio-thoracic Surgery, vol. 41, no. 2, pp. 423-426. https://doi.org/10.1016/j.ejcts.2011.05.041
Takayama, Hiroo ; Naka, Yoshifumi ; Kodali, Susheel K. ; Vincent, Julie A. ; Addonizio, Linda J. ; Jorde, Ulrich P. ; Willia, Mathew R. / A novel approach to percutaneous right-ventricular mechanical support. In: European Journal of Cardio-thoracic Surgery. 2012 ; Vol. 41, No. 2. pp. 423-426.
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AU - Jorde, Ulrich P.

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AB - Objective: We report our initial experience with our newly developed percutaneous right-ventricular assist device (VAD) with CentriMag (perc CM-RVAD). Methods: A flexible outflow cannula placed from the right internal jugular vein to the pulmonary artery and an inflow cannula placed from the femoral vein to the right atrium constituted the perc CM-RVAD. When needed, biventricular support was provided with left VAD (LVAD), either with a percutaneous LVAD placed through axillary or femoral artery access or with a fully implantable LVAD. Results: Between January 2009 and June 2010, all of the attempted patients successfully received perc CM-RVAD (n = 8). Mean blood pressure, heartrate, and central venous pressure showed a trend toward improvement after the perc CM-RVAD, with less inotrope/ vasopressor requirement. Mixed venous oxygen saturation (SvO2) increased significantly from 64 ± 20 Torr to 78 ± 6 Torr (P < 0.01). The percutaneous VADs were explanted after myocardial recovery in seven patients; however, in three of these, perc CM-RVAD was used as a temporary bridge to other devices. One patient was bridged to a surgical biventricular assist device (BiVAD)and transferred back to the referring hospital on support. One death occurred due to multiple-organfailure 8 days after explantation of the RVAD with recovery. Conclusions: Perc CM-RVAD was feasible and provided hemodynamic improvement.

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