455 Is Reduced Pump Speed Associated with Less Gastrointestinal Bleeding among Patients on Non-Pulsatile Left Ventricular Assist Devices?

Abstract

Purpose: Acute right ventricular dysfunction occurs in the setting of RV infarction, post cardiotomy, post left ventricular assist device and post cardiac transplant. Isolated acute right heart failure is relatively infrequent, but is usually associated with poor prognosis. Mechanical circulatory support is required in some cases. This is a case report of the use of a novel percutaneous right ventrivular assist device, Impella RP (Abiomed, USA) in a patient who developed acute right heart failure post transplant. Methods and Materials: A 59 year old male received a HeartMate II (Thoratec Corp, USA) as a bridge to tranplant. Patient underwent orthotopic heart tranplant with a prolonged ischemic time of six hours. Primary graft dysfunction requiring ECMO support which was weaned off 2 days post. Unfortunately, pateint developed cardiogenic shock secondary to acute right ventricular failure. An Impella RP device was inserted via the right femoral vein, advanced into the right atrium, across the tricuspid valve and into the main pulmanary artery over a guidewire.