title: Benefits of a novel percutaneous ventricular assist device for right heart failure: The prospective RECOVER RIGHT study of the Impella RP device.
abstract: BACKGROUND
  Right ventricular failure (RVF) increases morbidity and mortality. The RECOVER RIGHT study evaluated the safety and efficacy of a novel percutaneous right ventricular assist device, the Impella RP (Abiomed, Danvers, MA), in a prospective, multicenter trial.
  
  
  METHODS
  Thirty patients with RVF refractory to medical treatment received the Impella RP device at 15 United States institutions. The study population included 2 cohorts: 18 patients with RVF after left ventricular assist device (LVAD) implantation (Cohort A) and 12 patients with RVF after cardiotomy or myocardial infarction (Cohort B). The primary end point was survival to 30 days or hospital discharge (whichever was longer). Major secondary end points included indices of safety and efficacy.
  
  
  RESULTS
  The patients (77% male) were a mean age of 59 ± 15 years, 53% had diabetes, 88.5% had a history of congestive heart failure, and 37.5% had renal dysfunction. Patients were on an average of 3.2 inotropes/pressors. Device delivery was achieved in all but 1 patient. Hemodynamics improved immediately after initiation of Impella RP support, with an increase in cardiac index from 1.8 ± 0.2 to 3.3 ± 0.23 liters/min/m(2) (p < 0.001) and a decrease in central venous pressure from 19.2 ± 4 to 12.6 ± 1 mm Hg (p < 0.001). Patients were supported for an average of 3.0 ± 1.5 days (range, 0.5-7.8 days). The overall survival at 30 days was 73.3%. All patients discharged were alive at 180 days.
  
  
  CONCLUSIONS
  In patients with life-threatening RVF, the novel percutaneous Impella RP device was safe, easy to deploy, and reliably resulted in immediate hemodynamic benefit. These data support its probable benefit in this gravely ill patient population.
authors.affiliation: Division of Cardiothoracic Surgery and Department of Cardiovascular Medicine, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania. Electronic address: andersom@einstein.edu.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Anderson
authors.affiliation: Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, Michigan.
authors.forename: James
authors.initials: J
authors.lastname: Goldstein
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Milano
authors.affiliation: Division of Cardiothoracic Surgery and Department of Cardiovascular Medicine, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Lynn D
authors.initials: LD
authors.lastname: Morris
authors.affiliation: Division of Cardiothoracic Surgery, Artificial Heart Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kormos
authors.affiliation: Division of Cardiothoracic Surgery, Artificial Heart Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Jay
authors.initials: J
authors.lastname: Bhama
authors.affiliation: Department of Medicine, Cardiovascular Center, Tufts University Medical Center, Boston, Massachusetts.
authors.forename: Navin K
authors.initials: NK
authors.lastname: Kapur
authors.affiliation: Department of Cardiothoracic Surgery, Ochsner Foundation, New Orleans.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Division of Cardiothoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jose
authors.initials: J
authors.lastname: Garcia
authors.affiliation: Division of Cardiothoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Baker
authors.affiliation: Division of Cardiothoracic Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
authors.forename: Scott
authors.initials: S
authors.lastname: Silvestry
authors.affiliation: Division of Cardiothoracic Surgery, University of Alabama, Birmingham, Alabama.
authors.forename: William L
authors.initials: WL
authors.lastname: Holman
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Douglas
authors.affiliation: Center for Strucrural Heart Disease, Henry Ford Hospital, Detroit, Michigan.
authors.forename: William
authors.initials: W
authors.lastname: O'Neill
mesh_terms: D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design
keywords: cardiogenic shock; heart failure; hemodynamics; right ventricular assist device; right ventricular failure