German Heart Institute Berlin, Germany.
ASAIO J. 2012 Jan-Feb;58(1):15-8. doi: 10.1097/MAT.0b013e3182376b7b.
During biventricular assist device (BVAD) support, right ventricular (RV) assistance may restore sufficient RV function after several weeks to months. Since November 2009, 10 patients (9 men and 1 woman; mean age, 49.7 ± 14.4 y) suffering from idiopathic dilatative cardiomyopathy received BVAD employing two implantable continuous-flow pumps of the HeartWare type. In three male patients, aged 53, 57, and 60 years, after a right ventricular assist device (RVAD) support time of 15.6, 11.2, and 3.6 months, respectively, the RVAD was stopped, and the percutaneous lead was surgically shortened in two cases. There were no differences in preoperative RV geometry and function or in severity of tricuspid valve regurgitation in patients with and without delayed RV recovery. Follow-up echocardiography revealed no regurgitation through the right pump in any patient. One patient died due to severe sepsis 63 days later; the other two patients are currently on left ventricular assist devices support at home, 120 and 236 days after RVAD deactivation with stable hemodynamic conditions and without any thromboembolic events. RV function may recover even after weeks or months on BVAD support. The HeartWare HVAD used as an RVAD may be stopped and left in place without complications.
在双心室辅助装置 (BVAD) 支持期间，右心室 (RV) 辅助可能会在数周至数月后恢复足够的 RV 功能。自 2009 年 11 月以来，10 名（9 名男性和 1 名女性；平均年龄 49.7±14.4 岁）患有特发性扩张型心肌病的患者接受了使用 2 个 HeartWare 型植入式连续流泵的 BVAD。在 3 名年龄分别为 53、57 和 60 岁的男性患者中，RVAD 支持时间分别为 15.6、11.2 和 3.6 个月后，停止了 RVAD，并在 2 例中通过手术缩短了经皮导联。在 RV 恢复延迟的患者和无 RV 恢复延迟的患者中，术前 RV 几何形状和功能或三尖瓣反流严重程度没有差异。随访超声心动图显示没有任何患者的右泵出现反流。1 名患者因严重败血症 63 天后死亡；另外 2 名患者目前在家中接受左心室辅助装置支持，在 RVAD 停用后分别为 120 天和 236 天，血流动力学稳定，无任何血栓栓塞事件。即使在 BVAD 支持数周或数月后，RV 功能也可能恢复。用作 RVAD 的 HeartWare HVAD 可以停止并留在原处，没有并发症。
