Abstract
In approximately 10% of heart transplantation and long term left ventricular assist device patients, temporary assist of the right ventricle is needed to overcome acute failure post operatively. Based on the Impella® microaxial blood pump technology, a small, lightweight (17 gm), short-term right ventricular assist device (RVAD) was developed. The device’s 30 French inlet cage is inserted into the right atrium. A 24 French polytetrafluoroethylene outflow graft returns the blood to the pulmonary artery. The device is able to provide blood flow of 5.5 L/min. The Impella Recover RD is currently in clinical use in Europe and more than 50 patients have already been treated with this approach since 2002. Recent improvements in the monitoring and control algorithms (eg. periodic pulsed operation to improve washing) have helped to reduce the need for anticoagulation during support. A larger inflow cage was also incorporated to improve flow characteristics. Early clinical results (n=3, to date) of the improved version have been positive and will be described. In conclusion, the overall clinical experience with this RVAD has shown that its off-pump implantation has been extremely quick and easy. The device has proven to be ideal for short-term right ventricular support with excellent hemocompatibility and the ability to rapidly stabilize patients hemodynamically.
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