Advances in Mechanical Support for Right Ventricular Failure

Right Ventricular Failure

“…Studies have shown that survivors of RVF received mechanical RV support devices more rapidly than nonsurvivors, suggesting that early intervention may be beneficial. [9][10][11][12] Intra-aortic balloon pump (IABP) is a mechanical assistive device that can improve coronary perfusion and reduce LV afterload. Consisting of an inflatable balloon catheter inserted into the aorta, the device inflates during diastole and deflates during systole, augmenting cardiac output, reducing afterload, and increasing mean arterial pressure.…”

“…However, the Impella cannot oxygenate blood, so if oxygenation is required, upgrading to devices such as the Tandem-Heart, Protek Duo RVAD, or venoarterial ECMO (VA-ECMO) is necessary. [9][10][11][12] The TandemHeart and Protek Duo RVADs use extracorporeal centrifugal-flow pumps with inflow and outflow cannulas to deliver blood, and they can be attached to an external oxygenator device to function as venovenous ECMO (VV-ECMO). These devices can provide up to 4.5 L/min of blood flow but are associated with significant morbidity and mortality, necessitating careful patient selection and management.…”

“…These devices can reduce tricuspid regurgitation, enhance LV preload, and alleviate stress on the RV wall, providing temporary or long-term support. Studies have shown that survivors of RVF received mechanical RV support devices more rapidly than nonsurvivors, suggesting that early intervention may be beneficial 9–12…”

“…The device only requires one venous access site, typically the right femoral vein, and is deployed via a 23F venous peel-away sheath into the PA with a 0.018-in wire used as a monorail system. However, the Impella cannot oxygenate blood, so if oxygenation is required, upgrading to devices such as the TandemHeart, Protek Duo RVAD, or venoarterial ECMO (VA-ECMO) is necessary 9–12…”