Insertion of a biventricular assist device

2020 ◽  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Biventricular Assist Device ◽  
Left Ventricular Assist ◽  
Right Ventricular Assist Device ◽  
The Right ◽  
End Stage

This video tutorial demonstrates the insertion of a temporary biventricular assist device as a bridge to a heart transplant in a patient with end-stage heart failure with decompensation and increasing pulmonary pressure . This technique utilizes cardiopulmonary bypass to maintain hemodynamic stability throughout the procedure. Transesophageal echocardiography is used to guide the correct positioning of the ventricular cannulae. The cannulation sites include the right ventricle and the pulmonary artery for the right ventricular assist device and the left ventricular apex and the ascending aorta for the left ventricular assist device. The patient is weaned off cardiopulmonary bypass as the biventricular assist device flows are increased to the desired level. Following chest closure, the patient can be ambulatory with the device in situ.

Continuous-Flow Left Ventricular Assist Device and the Right Ventricle

2012 ◽  
Vol 23 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Mark Puhlman
Keyword(s):  
Right Ventricular ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Right Ventricular Failure ◽  
Ventricular Failure ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Right Ventricular Assist Device ◽  
The Right

Left ventricular assist devices (LVADs) have become accepted as treatment for heart failure as a result of improvements in diagnosing and treating left ventricular failure and limited donor availability. In the Pivotal Study of the HeartMate II in the bridge to transplantation population, the incidence of right ventricular failure without the implantation of a right ventricular assist device was 14%, with an additional 6% of the participants ill enough that they required implantation of a right ventricular assist device. This complication increases mortality, cost, and length of stay. This article reviews the screening of LVAD candidates for the probability of right ventricular failure postoperatively, the evaluation of right ventricular function in LVAD candidates, and the optimal management of the right ventricle during the perioperative care of LVAD patients.

scholarly journals Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis

Perfusion ◽  
2021 ◽  
pp. 026765912110248
Author(s):  
Gregory Reid ◽  
Constantin Mork ◽  
Brigita Gahl ◽  
Christian Appenzeller-Herzog ◽  
Ludwig K von Segesser ◽  
...  
Keyword(s):  
Systematic Review ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Device Implantation ◽  
Left Ventricular Assist ◽  
Right Ventricular Assist Device

Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation. Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models. Results: A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98–11.5%) versus 31.9% (19.78–44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2–19.4%) versus 40.0% (36.3–48.8%) and stroke rate was 5.6% (5.4–5.8%) versus 20.9% (16.8–28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73–23.59%) and 33.90% (CI 8.84–59.96%) in LVAD respectively versus 45.35% (CI 35.31–55.4%) p ⩽ 0.001 and 48.23% (CI 16.01–80.45%) p = 0.686 in LVAD/RVAD group respectively. Conclusion: Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke.

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