Birati Edo Y, Grandin E Wilson, Zhang Robert S, Cabezas Fausto, Rajagopal Keshava, Seigerman Matthew, Padegimas Allison, Mazurek Jeremy A, Kiernan Michael S, Kapur Navin K, Atluri Pavan, Oliveira Guilherme H, Pagani Francis D, Myers Susan L, Teuteberg Jeffrey, Kormos Robert L, Kirklin James K, Acker Michael A, Eduardo Rame Jesus
Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Cardiology, Tzafon (Poriya) Medical Center, Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel.
JHLT Open. 2025 Apr 1;8:100258. doi: 10.1016/j.jhlto.2025.100258. eCollection 2025 May.
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.
使用专为左心室设计的泵的单纯右心室辅助装置（iRVAD）的治疗结果尚无充分描述。本研究比较了iRVAD患者与接受左心室辅助装置（LVAD）和双心室辅助装置（BiVAD）治疗的患者的临床特征和治疗结果。本研究纳入了从机构间机械辅助循环支持注册中心（INTERMACS）注册库（2006 - 2017年）接受iRVAD治疗的患者。主要结局是2年生存率。在20789例患者中，26例（0.13%）接受了iRVAD治疗，其中17例使用搏动血流装置，9例使用连续血流装置。装置策略为过渡到恢复/抢救治疗的有9例（35%），过渡到移植/决策的有14例（52%），目标治疗的有3例（12%）。12例（46%）患者为INTERMACS 1型，5例（19%）需要体外膜肺氧合，13例（50%）需要机械通气。iRVAD患者的2年生存率（41.3%）与BiVAD患者（45.2%）相似，但显著低于LVAD患者（69.0%）。在单纯右侧心力衰竭患者中，长期iRVAD支持是可行的。
