Right ventricular assist devices and the surgical treatment of right ventricular failure.
Treatment of patients with severe right ventricular dysfunction follows a continuum of progressive therapies. If optimization of volume status and inotropic support do not adequately improve right ventricular function, higher levels of mechanical circulatory support are required. A right-sided intraaortic balloon pump has been helpful in such circumstances. The centrifugal pump and the artificial ventricle provide the most effective long-term circulatory support for patients with right ventricular or biventricular failure after cardiopulmonary bypass, myocardial infarctions, or as a bridge to cardiac transplantation. All of these support measures still carry a high morbidity and mortality. Survival in approximately one third of these high-risk patients can be expected with the use of right ventricular assist devices. Cardiopulmonary bypass has also been effective for circulatory support of patients with massive pulmonary emboli.
Higgins
R S
RS
Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Connecticut.
Elefteriades
J A
JA
D002315:Cardiopulmonary Bypass; D015908:Counterpulsation; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D011655:Pulmonary Embolism / Q000628:therapy; D016278:Ventricular Function, Right / Q000502:physiology*