title: Biventricular failure with low pulmonary vascular resistance was managed by left ventricular assist device alone without right-sided mechanical support.
abstract: How to manage preoperative right ventricular dysfunction (RVD) in heart failure patients without cardiogenic shock remains as a matter to be debated because implantable biventricular assist device treatment has not been established thus far. We here presented a patient with significant RVD indicated by low RV stroke work index (0.3 g/m) and RV dilatation as well as low pulmonary vascular resistance (PVR, 0.8 Wood Unit), who was managed by the introduction of pimobendan and sildenafil after the implantation of DuraHeart and tricuspid annuloplasty without right VAD, although his New York Heart Association symptom remained class III. Preoperative low PVR may be a key for successful LVAD treatment alone without right VAD in patients with INTERMACS profile 3 suffering RVD.
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, imamurate-int@h.u-tokyo.ac.jp.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nitta
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Kan
authors.initials: K
authors.lastname: Nawata
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D000328:Adult; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D014655:Vascular Resistance; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*