Cavopulmonary anastomosis improves left ventricular assist device support in acute biventricular failure☆☆☆

Abstract

The concomitant use of cavopulmonary anastomosis during LVAD support in a model of severe biventricular failure limited right ventricular overloading and resulted in better hemodynamic performance.

Cavo-pulmonary anastomosis associated with left ventricular in comparison with biventricular circulatory support in acute heart failure

“…Cavopulmonary anastomosis seems to be able to increase the effective pulmonary flow because volumetrically decompresses the RV, restoring its geometric shape [7,13]. There are clinical [8] and experimental [7,9] suggestions in the literature that the partial exclusion of the RV is beneficial in the treatment of right failure.…”

“…Another factor to be considered is again the time, because even though the animals have been exposed in this study to VF twice as long compared to the protocol used previously in the study by Succi et al [7], there was no significant hemodynamic deterioration during the period of observation, and so maybe cavopulmonary anastomosis decompression has not shown the expected hemodynamic efficacy.…”

“…There are clinical [8] and experimental [7,9] suggestions in the literature that the partial exclusion of the RV is beneficial in the treatment of right failure.…”

“…However, despite the observed hemodynamic improvement, it is known that this type of assistance, despite the technological advances offered by new devices, it still remains high incidence of complications [7,14,16]. To that end, numerous studies are listed in an attempt to elucidate the criteria that could predict which patients are at higher risk of developing RV failure after the LVAD institution.…”

“…Another alternative that has been suggested recently to acute right ventricular failure is the use of its surgical volume decompression volume through the cavopulmonary shunt [7,8]. The effectiveness of this procedure has been proven previously in experimental studies [9] and there…”