title: Implantation of the Biomedicus centrifugal pump in post-transplant right heart failure.
abstract: BACKGROUND
  Right heart failure after heart transplantation represents a life-threatening complication. When conventional therapy including NO-inhalation fails the only choice to reach sufficient haemodynamic conditions may be the implantation of a right ventricular support system.
  
  
  METHODS
  In all cases the Biomedicus centrifugal pump was implanted by cannulation of the right atrium and pulmonary artery.
  
  
  RESULTS
  Since March 1989 950 heart transplant procedures were performed at our center. In nine cases (7 male, 2 female, mean age 52 years) implantation of a right ventricular support system was necessary because of deterioration of right ventricular function. The implantation was carried out in 7 cases immediately after transplantation, in 2 cases after 2 days. The support time ranged from 4-348 hours. Six patients could be weaned, 2 patients underwent retransplantation and died and 1 patient died on the support system. Three of the six weaned patients died in the further course because of multiorgan failure.
  
  
  CONCLUSIONS
  Mechanical right ventricular support is often the only therapeutical tool to reach adequate haemodynamic conditions in post-transplant right heart failure. The Biomedicus centrifugal pump provides good conditions in these cases. Weaning is often possible after short-term support. The mortality rate is determined by multiorgan failure in immuno-suppressed patients. Retransplantation seems not to be successful despite maximal treatment.
authors.affiliation: Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Reiss
authors.forename: A
authors.initials: A
authors.lastname: El-Banayosy
authors.forename: N
authors.initials: N
authors.lastname: Mirow
authors.forename: K
authors.initials: K
authors.lastname: Minami
authors.forename: R
authors.initials: R
authors.lastname: Körfer
mesh_terms: D005112:Extracorporeal Circulation / Q000295:instrumentation*; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000628:therapy