Impella RP as a bridge to cardiac transplant for refractory late right ventricular failure in setting of left ventricular assist device

We report the first successful case of extended Impella RP use as a safe and effective bri dge to orthotopic heart transplant in an LVAD patient with refractory, haemodynamically significant late RV failure. The Impella RP provided support for 37 days. Haemodynamically intolerant arrhythmia precluded use of inotropic support. No adverse complications related to percutaneous Impella RP su pport were seen. We also review potential considerations for mechanical circulatory support strategies in this setting: central RV assist device cannulation requires sternotomy incision that can impact subsequent cardiac surgeries, while percutaneous Protek Duo insertion requires adequate vessel siz e and patency. With an LVADin situ, veno ‐arterial extracorporeal membrane oxygenation was not considered for isolated RV support in this case. The patient is currently over 6 months post‐orthotopic heart transplant.

Source: ESC Heart Failure - May 18, 2020 Category: Cardiology Authors: Varinder Kaur Randhawa, Karlee Hoffman, Ashley Bock, Pavan Bhat, Laura Young, Jeffrey Rossi, Joseph Campbell, Corrine Bott ‐Silverman, Edward G. Soltesz, Michael Z.Y. Tong, Shinya Unai, Ravi Nair, Jerry D. Estep, Antonio L. Perez Tags: Case Report Source Type: research