Different ECLS Pump Configurations for Temporary Right Ventricular Assist Device in LVAD Patients: A Retrospective Case-Control Study.

BACKGROUND

Acute right ventricular failure is a critical complication after left ventricular assist device (LVAD) implantation, often managed with a temporary paracorporeal right ventricular assist device (RVAD). This study examined three extracorporeal life support (ECLS) systems regarding mortality, bleeding complications, and intensive care unit (ICU) stay duration.

METHODS

This monocentric, retrospective case-control study included all patients receiving LVAD with paracorporeal RVAD between 2009 and 2020. Three patient groups were formed: Centrimag (A), Cardiohelp (B), and Deltastream (C).

RESULTS

A total of 245 patients were included. Preoperative parameters were similar between the Centrimag and Deltastream groups, but Cardiohelp patients had worse Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Scores (A: 1.7 ± 0.8, B: 1.36 ± 0.5, C: 1.9 ± 0.9; < 0.05). In-hospital death rates were A: 61 (41.8%), B: 15 (32.6%), C: 29 (54.7%); < 0.05, and reoperation due to bleeding rates were A: 32 (21.9%), B: 8 (17.4%), C: 25 (47.2%); < 0.05, with the Deltastream group showing the highest rates. This group also had increased thrombocyte consumption and prolonged ICU stays.

CONCLUSIONS

Temporary RVADs lead to bleeding complications, affecting patient outcomes. The Deltastream group had significantly higher bleeding complications, likely due to high pump revolution rates and thrombocyte decline. Due to the study's retrospective nature and complex patient profiles, these interesting findings should be validated in future studies.