Outcomes following isolated right ventricular assist device as durable support for primary right heart failure: An INTERMACS analysis

JHLT Open Pub Date : 2025-04-01 DOI:10.1016/j.jhlto.2025.100258

Edo Y. Birati MD , E. Wilson Grandin MD, MPH , Robert S. Zhang MD , Fausto Cabezas MD , Keshava Rajagopal MD, PhD , Matthew Seigerman MD , Allison Padegimas MD , Jeremy A. Mazurek MD , Michael S. Kiernan MD , Navin K. Kapur MD , Pavan Atluri MD , Guilherme H. Oliveira MD , Francis D. Pagani MD , Susan L. Myers , Jeffrey Teuteberg MD , Robert L. Kormos MD , James K. Kirklin MD , Michael A. Acker MD , Jesus Eduardo Rame MD

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Abstract

Outcomes with isolated right ventricular assist devices (iRVAD) using pumps designed for the left ventricle are not well described. This study compares the clinical characteristics and outcomes of iRVAD patients to those patients treated with left ventricular assist device (LVAD) and biventricular assist devices (BiVAD). This study consisted of patients who received iRVAD from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry (2006-2017). The primary outcome was 2-year survival. Of 20,789 patients, 26 (0.13%) received iRVAD, 17 with pulsatile flow and 9 with continuous-flow devices. Device strategy was bridge to recovery/rescue therapy in 9 (35%), bridge to transplant/decision in 14 (52%), and destination therapy in 3 (12%). Twelve (46%) patients were INTERMACS profile 1, 5 patients (19%) required extracorporeal membrane oxygenation, and 13 (50%) needed mechanical ventilation. Two-year survival for patients with iRVAD (41.3%) was similar to BiVAD (45.2%) and significantly lower than LVAD (69.0%). In patients with isolated right-sided failure, long-term iRVAD support is feasible.

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将孤立右心室辅助装置作为原发性右心衰竭的持久支持装置后的疗效：INTERMACS 分析

使用为左心室设计的泵的孤立性右心室辅助装置（iRVAD）的结果尚未得到很好的描述。本研究比较了iRVAD患者与左心室辅助装置（LVAD）和双心室辅助装置（BiVAD）治疗患者的临床特征和预后。本研究包括从机构间机械辅助循环支持登记处（INTERMACS）登记处（2006-2017）接受iRVAD的患者。主要终点为2年生存率。在20,789例患者中，26例（0.13%）接受了iRVAD， 17例采用脉动流装置，9例采用连续流装置。器械策略为过渡到恢复/抢救治疗9例（35%），过渡到移植/决定治疗14例（52%），终点治疗3例（12%）。12例（46%）患者符合INTERMACS 1型，5例（19%）患者需要体外膜氧合，13例（50%）患者需要机械通气。iRVAD患者的两年生存率（41.3%）与BiVAD（45.2%）相似，显著低于LVAD（69.0%）。对于孤立性右侧功能衰竭患者，长期iRVAD支持是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JHLT Open

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