Journal Article

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

Opacic, Dragan, Rudloff, Markus, Radakovic, Darko, Velasquez-Silva, Claudio, Deutsch, Marcus-André, Rojas, Sebastian V., Klüß, Christian, Fox, Henrik, Schramm, René, El-Hachem, Georges, Becker, Tobias, Morshuis, Michiel, Lauenroth, Volker, Gummert, Jan F.

2024

Overview

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: CentrimagTM (A), CardiohelpTM (B), and DeltastreamTM (C). Results: A total of 245 patients were included. Preoperative parameters were similar between the CentrimagTM and DeltastreamTM groups, but CardiohelpTM 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; p < 0.05). In-hospital death rates were A: 61 (41.8%), B: 15 (32.6%), C: 29 (54.7%); p < 0.05, and reoperation due to bleeding rates were A: 32 (21.9%), B: 8 (17.4%), C: 25 (47.2%); p < 0.05, with the DeltastreamTM 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 DeltastreamTM 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.

• Publisher: MDPI AG,MDPI
• Subject: acute right ventricular failure / Bleeding / Blood oxygenation, Extracorporeal / Cardiomyopathy / Case studies / Catecholamines / Equipment and supplies / extracorporeal life support pump configurations / Heart / Heart failure / Ischemia / left ventricular assist device / Methods / Mortality / paracorporeal right ventricular assist device / Patients / Prostheses / Pulmonary arteries / Right ventricular failure / Statistical analysis / Surgical apparatus & instruments / Thrombocytes / Transplants & implants / Ventricle / Ventricular assist devices / Weaning