Temporary right ventricular support with Impella Recover RD axial flow pump.
Post-cardiotomy right ventricular failure is a serious complication that frequently results in adverse outcomes. We reviewed our experience with the Impella Recover RD (Impella Cardiosystems GMbH, Aachen, Germany). From January 2007 to December 2007, 7 patients (5 males, 54 +7 years old) had this device implanted for temporary support after heart transplantation in 4, after repeat mitral valve replacement in 2, and with a left ventricular assist device in 1. Devices were implanted during initial operation (n =5) or shortly thereafter (n =2). Six patients underwent implantation without cardiopulmonary bypass. Effective support with pump flows of 4.0-4.5 L x min(-1) and adequate unloading (central venous pressure decreased from 15.3 +/- 1.4 to 9.4 +/- 1.2 mm Hg) was achieved in all patients. Patients were assisted for a mean duration of 4.9 +/- 4.5 days. Three patients could be weaned after 7.0 +/- 5.6 days of support and underwent device explantation without cardiopulmonary bypass. One of these patients died of recurrent right ventricular failure, 2 remained stable but died later of sepsis. The patient with a left ventricular assist device was switched to an alternative device for prolonged support. Two patients experienced pump dysfunction. Our preliminary experience shows that the Impella Recover RD is an effective device that can be easily implanted and explanted. However, its mechanical reliability needs to be improved.
Sugiki
Hiroshi
H
Department of Cardiothoracic Surgery, Henri Mondor Hospital, Créteil, France. Hsugiki@aol.com
Nakashima
Kuniki
K
Vermes
Emmanuelle
E
Loisance
Daniel
D
Kirsch
Matthias
M
D002315:Cardiopulmonary Bypass; D020878:Device Removal; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D006353:Heart-Assist Devices / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D009200:Myocardial Contraction; D010865:Pilot Projects; D012008:Recurrence; D012086:Reoperation; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*