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Isolated Right Ventricular Mechanical Support: Outcomes and Prognosis

Mulaikal, Teresa A.*; Bell, Laura H.; Li, Boyangzi; Wagener, Gebhard*; Takayama, Hiroo

doi: 10.1097/MAT.0000000000000597
Case Series: PDF Only

Right ventricular (RV) failure that necessitates isolated mechanical support is extremely rare. Outcomes have not been described and are limited to case reports. We sought to evaluate this select group of patients and determine their 30 day and 1 year survival. We retrospectively reviewed the Mechanical Assist Device Database at Columbia University from 2007 to 2015. Inclusion criteria consisted of patients who received isolated RV assist devices (RVADs) without mechanical support of the left ventricle. We evaluated survival, duration of support, intensive care unit (ICU) length of stay, and adverse events. There were 55 patients who underwent RVAD placement between February 2007 and April 2015. Eleven of these patients received isolated RVADs in the absence of mechanical circulatory support of the left ventricle. Average duration of support was 13.6 days with a median duration of 12 days. Thirty day and 1 year survival was 72.7% and 54.6%, respectively. This case series is the first to describe 30 day and 1 year outcomes for patients with isolated RV mechanical support. We propose an interdisciplinary institutional algorithm based on our study population that maximizes medical therapy and then pursues invasive forms of mechanical support when end-organ damage persists.

From the *Division of Cardiothoracic and Critical Care Medicine, Department of Anesthesiology, Columbia University Medical Center, New York, New York; Division of Cardiovascular Anesthesia and Critical Care Medicine, Texas Heart Institute at Baylor St. Luke’s Medical Center, Houston, Texas; and Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.

Submitted for consideration September 2016; accepted for publication in revised form March 2017.

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

Correspondence: Teresa A. Mulaikal, Division of Cardiac and Critical Care Anesthesiology, Columbia University Medical Center, 622 W. 168th Street, PH 5–505, New York, NY 10032. Email:

Copyright © 2018 by the American Society for Artificial Internal Organs