Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation.

Szczegóły
Abstrakt

Tytuł:: Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation.
Autorzy:: Lee SK; Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Kim DH; Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Cho WH; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Yeo HJ; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
Źródło:: Transplantation [Transplantation] 2021 Jul 01; Vol. 105 (7), pp. 1610-1614.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Williams & Wilkins.
MeSH Terms:: Heart-Assist Devices*
Lung Transplantation*
Ventricular Function, Right*
Heart Failure/*therapy
Lung Diseases/*surgery
Prosthesis Implantation/*instrumentation
Aged ; Feasibility Studies ; Female ; Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/physiopathology ; Humans ; Lung Diseases/complications ; Lung Diseases/diagnosis ; Lung Diseases/physiopathology ; Male ; Middle Aged ; Prosthesis Design ; Prosthesis Implantation/adverse effects ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Treatment Outcome
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Yeo HJ, Jeon D, Kim YS, et al. Veno-veno-arterial extracorporeal membrane oxygenation treatment in patients with severe acute respiratory distress syndrome and septic shock. Crit Care. 2016; 20:28.
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Oh DK, Shim TS, Jo KW, et al. Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation. Acute Crit Care. 2020; 35:117–121.
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Schechter MA, Ganapathi AM, Englum BR, et al. Spontaneously breathing extracorporeal membrane oxygenation support provides the optimal bridge to lung transplantation. Transplantation. 2016; 100:2699–2704.
Murphy DA, Hockings LE, Andrews RK, et al. Extracorporeal membrane oxygenation-hemostatic complications. Transfus Med Rev. 2015; 29:90–101.
Kon ZN, Pasrija C, Shah A, et al. Venovenous extracorporeal membrane oxygenation with atrial septostomy as a bridge to lung transplantation. Ann Thorac Surg. 2016; 101:1166–1169.
Arpesella G, Mikus E, Loforte A, et al. Right-left atrium by-pass as salvage treatment for graft failure after heart transplantation. Eur J Cardiothorac Surg. 2007; 32:671–673.
Mohite PN, Sabashnikov A, De Robertis F, et al. Oxy-RVAD: rescue in pulmonary complications after LVAD implantation. Perfusion. 2015; 30:596–599.
Yeo HJ, Kim DH, Jeon D, et al. Low-dose heparin during extracorporeal membrane oxygenation treatment in adults. Intensive Care Med. 2015; 41:2020–2021.
Nadeem K, Ng BC, Lim E, et al. Numerical simulation of a biventricular assist device with fixed right outflow cannula banding during pulmonary hypertension. Ann Biomed Eng. 2016; 44:1008–1018.
Entry Date(s):: Date Created: 20200918 Date Completed: 20210726 Latest Revision: 20210726
Update Code:: 20240104
DOI:: 10.1097/TP.0000000000003459
PMID:: 32947584
: Czasopismo naukowe

Background: Right heart failure develops in lung transplantation candidates on extracorporeal membrane oxygenation (ECMO) support and increases mortality. The safety and feasibility of the oxy-right ventricular assist device (oxyRVAD) as a bridge to lung transplantation in severe right heart failure caused by terminal lung disease have not been evaluated.
Methods: We retrospectively reviewed 14 patients who used oxyRVAD for bridging of right heart failure to lung transplantation.
Results: The major cause of lung transplantation was acute exacerbation of interstitial lung disease (78.6%), and the median venovenous ECMO duration was 7 d. Before oxyRVAD, median mean pulmonary artery pressure was 60.5 mm Hg (interquartile range [IQR], 54-68), and the median peak tricuspid regurgitation velocity was 3.9 m/s (IQR, 3.7-4.1). After oxyRVAD conversion, median mean pulmonary artery pressure was 60.5 mm Hg (IQR, 57.3-65), and the median peak tricuspid regurgitation velocity was 2.9 (IQR, 2.6-3.2). All patients were hemodynamically stable (median arterial blood pressure, 83 mm Hg; median heart rate, 79 bpm). Three patients developed pulmonary congestion (21.4%), and all patients stabilized within 24 h. Active rehabilitation during ECMO was possible in all patients, and the median duration of awake state during ECMO was 14 d. A total of 10 patients were bridged successfully to lung transplantation, and hospital survival rates were 90%.
Conclusions: OxyRVAD stabilized hemodynamic parameters without fatal complications, permitted the discontinuation of sedation, and allowed active rehabilitation in patients with severe right heart failure. OxyRVAD may be a feasible option for bridging of right heart failure to lung transplantation.
Competing Interests: The authors declare no funding or conflicts of interest.
(Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

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