Abstract
Acute right ventricular failure after cardiac surgery occurring in the first postoperative hours is associated with a bad prognosis. We have used a centrifugal pump either for left, right or biventricular assistance. However, the use of this device for pure right ventricular assistance is rare. We report a 30 year-old female undergoing a mitral valve replacement and a 42 year-old male undergoing a cardiac transplantation, who had a successful right ventricular assistance using a centrifugal pump, due to a failing right ventricle, as the result of insufficient myocardial protection and severe pulmonary hypertension. These two cases illustrate the value of the mechanical ventricular assist device for the treatment of right heart failure.
Highlights
Acute right ventricular failure after cardiac surgery occurring in the first postoperative hours is associated with a bad prognosis
Ésta puede manifestarse en el paciente sometido a trasplante cardiaco, en los portadores de valvulopatía mitral con resistencia vascular pulmo
Reevaluating the significance of pulmonary hypertension before cardiac transplantation: determination of optimal thresholds and quantification of the effect of reversibility on perioperative mortality
Summary
Oneglio Pedemonte V1, Ernesto Aránguiz Santander[1], Humberto Torres H1, Lorenzo Merello N1, Andrés Vera P1, Rienzi Díaz N2, Jorge Kaplán M1. Actualmente, a los 15 años del reemplazo mitral y del procedimiento descrito, la paciente se encuentra en CF I y en ASISTENCIA VENTRICULAR DERECHA CON BOMBA CENTRÍFUGA - O Pedemonte et al Figura 1. Al retiro de la CEC, se evidenció una hipertensión pulmonar severa que provocó una falla ventricular derecha catastrófica, que requirió de tratamiento con inótropos, vasopresores, balón de contrapulsación aórtico (BCPA) y, finalmente, AVD con bomba centrífuga. El tratamiento descrito se mantuvo inalterable durante las primeras 72 h, lo que permitió una mejoría de la condición hemodinámica (Figura 3), por lo que se pudo lograr el retiro del apoyo inotrópico (Figura 4). A la 3a semana, el paciente fue dado de alta hospitalaria en CF I, sin hipertensión pulmonar ni falla ventricular derecha
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