[Effect of RVAD for right heart failure involved with right ventricular infarction--especially studies of myocardial regional blood flow and epicardial mapping electrocardiography].

In recent years, the number of cases in which a ventricular assist device is required for serious heart failure not responding to conventional mechanical circulatory assistance, has been increasing. It should be pointed out, however, that the majority of the new device is to assist the left ventricle, and that the effect of right ventricular assist device (RVAD) has not been fully clarified yet. The effect of RVAD and intra-aortic balloon pumping (IABP) on right ventricular failure due to right ventricular infarction was studied in swine. Right ventricular infarction was made by means of right coronary artery ligation. After preparation of right ventricular infarction, both mean aortic pressure and cardiac output were reduced and elevated central venous pressure, increased right ventricular end-diastolic pressure, dilatation of right ventricular free wall, were noted and diagnosed as a cardiogenic shock due to acute right ventricular infarction. Right ventricular infarcted area was evaluated by epicardial mapping ECG and myocardial regional blood flow. It was found that in the cases using IABP, the effect of reducing the infarcted area due to diastolic augmentation was noted, but the effect on the right ventricular support was not satisfactory, while in the cases using RVAD, the right ventricular preload was reduced and the right ventricular stroke work was decreased, and the effect of reducing the infarcted area was observed. But hemodynamic effect of these method were not satisfactory, enough to assist recovery from cardiogenic shock.(ABSTRACT TRUNCATED AT 250 WORDS)