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Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices.

Publication ,  Journal Article
Arabía, FA; Milano, CA; Mahr, C; McGee, EC; Mokadam, NA; Rame, JE; Moriguchi, JD; Ramzy, D; Naftel, DC; Myers, SL; Kirklin, JK
Published in: Ann Thorac Surg
February 2018

BACKGROUND: The incidence of right ventricular dysfunction requiring right ventricular assist device after left ventricular assist device placement has been reported between 10% to 30%. The mortality rate is higher compared with patients who require left ventricular assist device only; the most effective and safest biventricular assist device remains unknown. We aimed to determine the survival outcomes and frequency of adverse events in patients with two durable, intracorporeal, continuous flow centrifugal pumps for support. METHODS: Between November 2012 and June 2015, 38 patients were identified from INTERMACS received durable, intracorporeal continuous flow centrifugal pumps for biventricular support. Pediatric patients were excluded. Mean age was 47 years, and 74% of patients were male. The common primary diagnoses in this cohort were dilated myopathy, idiopathic (37%) and ischemic (16%). RESULTS: Nineteen participating centers implanted devices in 38 patients; 11 patients died with device in place, 9 patients received a heart transplant, and 18 were alive on support with the right ventricular assist device in place. Survival outcomes were 68% at 6 months and 62% at 12 months. The left ventricular assist device was placed in the left ventricle apex in 91% of cases, and in 9%, the location was not specified. The right ventricular assist device was placed in the right ventricle in 50%, right atrium in 37%, and not specified in 13%. The adverse events included infection 50%, bleeding 44%, respiratory failure 31.6%, and malfunction 26.3%; neurologic dysfunction 26.3%; renal dysfunction 18.4%; and arrhythmia 18.4%. CONCLUSIONS: The use of durable, intracorporeal, continuous flow centrifugal pumps for management of advanced biventricular heart failure is associated with high morbidity and mortality. Further investigation of this device configuration is warranted.

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

February 2018

Volume

105

Issue

2

Start / End Page

548 / 555

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Ventricular Dysfunction, Right
  • United States
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Prosthesis Design
  • Middle Aged
 

Citation

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ICMJE
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Arabía, F. A., Milano, C. A., Mahr, C., McGee, E. C., Mokadam, N. A., Rame, J. E., … Kirklin, J. K. (2018). Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices. Ann Thorac Surg, 105(2), 548–555. https://doi.org/10.1016/j.athoracsur.2017.08.019
Arabía, Francisco A., Carmelo A. Milano, Claudius Mahr, Edwin C. McGee, Nahush A. Mokadam, J Eduardo Rame, Jaime D. Moriguchi, et al. “Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices.Ann Thorac Surg 105, no. 2 (February 2018): 548–55. https://doi.org/10.1016/j.athoracsur.2017.08.019.
Arabía FA, Milano CA, Mahr C, McGee EC, Mokadam NA, Rame JE, et al. Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices. Ann Thorac Surg. 2018 Feb;105(2):548–55.
Arabía, Francisco A., et al. “Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices.Ann Thorac Surg, vol. 105, no. 2, Feb. 2018, pp. 548–55. Pubmed, doi:10.1016/j.athoracsur.2017.08.019.
Arabía FA, Milano CA, Mahr C, McGee EC, Mokadam NA, Rame JE, Moriguchi JD, Ramzy D, Naftel DC, Myers SL, Kirklin JK. Biventricular Support With Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices. Ann Thorac Surg. 2018 Feb;105(2):548–555.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

February 2018

Volume

105

Issue

2

Start / End Page

548 / 555

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Ventricular Dysfunction, Right
  • United States
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Prosthesis Design
  • Middle Aged