title: Mechanical circulatory support for right heart failure: current technology and future outlook.
abstract: The increasing global prevalence of congestive heart failure is a major healthcare concern, accounting for a high morbidity rate worldwide. In particular, isolated right heart dysfunction after cardiotomy has a poor prognosis and is associated with a high mortality rate. The occurrence of postoperative right heart failure may develop in more than 40% of patients undergoing implantation of a left ventricular assist device (LVAD) and cardiac transplantation. To date, mechanical cardiac assistance in the form of VADs has become accepted as a therapeutic solution for end-stage patients when a donor heart is not available. However, right ventricular (RV) assistance is still in the early phase of development when compared with LVAD technology. State-of-the-art RVADs, both in clinical use and under development, are reviewed in this manuscript. Clinical RVADs include the extracorporeal pulsatile Abiomed BVS 5000 and AB5000, Thoratec PVAD, MEDOS VAD, BerlinHeart Excor, the percutaneous continuous flow CentriMag and TandemHeart systems, and the implantable Thoratec IVAD. Devices on the horizon, including the wear-free implantable DexAide and the minimally invasive Impella RD, are additionally reviewed. In addition to the current status of RV assistance, as well as the device categorization, the outlook and considerations for successful development of future RVADs were discussed.
authors.affiliation: Department of Cardiovascular Engineering Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Germany. hsu@hia.rwth-aachen.de
authors.forename: Po-Lin
authors.initials: PL
authors.lastname: Hsu
authors.forename: Jack
authors.initials: J
authors.lastname: Parker
authors.forename: Christina
authors.initials: C
authors.lastname: Egger
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Autschbach
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmitz-Rode
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
mesh_terms: D004867:Equipment Design; D005112:Extracorporeal Circulation / Q000295:instrumentation; D006333:Heart Failure / Q000601:surgery* / Q000628:therapy; D006352:Heart Ventricles / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans