Outcomes following isolated right ventricular assist device as durable support for primary right heart failure: An INTERMACS analysis
Edo Y. Birati, MD,
E. Wilson Grandin, MD, MPH,
Robert S. Zhang, MD,
Fausto Cabezas, MD,
Keshava Rajagopal, MD, PhD,
Matthew Seigerman, MD,
Allison Padegimas, MD,
Jeremy A. Mazurek, MD,
Michael S. Kiernan, MD,
Navin K. Kapur, MD,
Pavan Atluri, MD,
Guilherme H. Oliveira, MD,
Francis D. Pagani, MD,
Susan L. Myers,
Jeffrey Teuteberg, MD,
Robert L. Kormos, MD,
James K. Kirklin, MD,
Michael A. Acker, MD,
Jesus Eduardo Rame, MD
Affiliations
Edo Y. Birati, MD
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
E. Wilson Grandin, MD, MPH
Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Robert S. Zhang, MD
Division of Cardiovascular Medicine, Weill Cornell Medicine, New York, New York
Fausto Cabezas, MD
Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Keshava Rajagopal, MD, PhD
Division of Cardiac Surgery, Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
Matthew Seigerman, MD
Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Allison Padegimas, MD
Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Jeremy A. Mazurek, MD
Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Michael S. Kiernan, MD
Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
Navin K. Kapur, MD
Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
Pavan Atluri, MD
Division of Cardiothoracic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Guilherme H. Oliveira, MD
Division of Cardiology, Tampa General Hospital, Morsani College of Medicine, Tampa, Florida
Francis D. Pagani, MD
Division of Cardiothoracic Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan
Susan L. Myers
Division of Cardiothoracic Surgery, University of Alabama Birmingham School of Medicine, Birmingham, Alabama
Jeffrey Teuteberg, MD
Division of Cardiology, Stanford University Hospital, Palo Alto, California
Robert L. Kormos, MD
University of Pittsburgh, Pittsburgh, Pennsylvania
James K. Kirklin, MD
Division of Cardiothoracic Surgery, University of Alabama Birmingham School of Medicine, Birmingham, Alabama
Michael A. Acker, MD
Division of Cardiothoracic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Jesus Eduardo Rame, MD
Jefferson Bruce and Robbi Toll Heart and Vascular Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; Corresponding author: Jesus Eduardo Rame, Jefferson Heart Institute, 925 Chestnut Street, Suite 300, Philadelphia, PA 19107.
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.
