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Mechanical Circulatory Support of the Right Ventricle for Adult and Pediatric Patients With Heart Failure

Chopski, Steven G.*; Murad, Nohra M.*; Fox, Carson S.*; Stevens, Randy M.†,‡; Throckmorton, Amy L.*

doi: 10.1097/MAT.0000000000000815
Review Article

The clinical implementation of mechanical circulatory assistance for a significantly dysfunctional or failing left ventricle as a bridge-to-transplant or bridge-to-recovery is on the rise. Thousands of patients with left-sided heart failure are readily benefitting from these life-saving technologies, and left ventricular failure often leads to severe right ventricular dysfunction or failure. Right ventricular failure (RVF) has a high rate of mortality caused by the risk of multisystem organ failure and prolonged hospitalization for patients after treatment. The use of a blood pump to support the left ventricle also typically results in an increase in right ventricular preload and may impair right ventricular contractility during left ventricular unloading. Patients with RVF might also suffer from severe pulmonary dysfunction, cardiac defects, congenital heart disease states, or a heterogeneity of cardiophysiologic challenges because of symptomatic congestive heart failure. Thus, the uniqueness and complexity of RVF is emerging as a new domain of significant clinical interest that motivates the development of right ventricular assist devices. In this review, we present the current state-of-the-art for clinically used blood pumps to support adults and pediatric patients with right ventricular dysfunction or failure concomitant with left ventricular failure. New innovative devices specifically for RVF are also highlighted. There continues to be a compelling need for novel treatment options to support patients with significant right heart dysfunction or failure.

From the *BioCirc Research Laboratory, School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, Pennsylvania

St. Christopher’s Hospital for Children, Tenet Healthcare Corporation, Philadelphia, Pennsylvania

Division of Pediatrics, College of Medicine, Drexel University, Philadelphia, Pennsylvania.

Submitted for consideration August 2017; accepted for publication in revised form March 2018.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Amy Throckmorton, School of Biomedical Engineering, Science, and Health Systems, Bossone Research Enterprise Center, Drexel University, 3141 Chestnut Street, Room 718, Philadelphia, PA. Email:

Copyright © 2019 by the American Society for Artificial Internal Organs