Temporary Right Heart Support Following LVAD Implantation in High Risk Patients with Dual Mechanical Support Combining Veno-arterial ECLS and Impella Microaxial Pump

Abstract

Objectives: Dual mechanical support combining veno-arterial (VA) ECLS and Impella microaxial pump rescues high-risk patients in refractory cardiogenic shock and biventricular failure. An implantation of a permanent ventricular assist device (VAD) is a life-saving procedure for these patients if cardiac function does not recover under biventricular unloading. However, many questions centering on perioperative right heart failure (RHF) and stabilization of right ventricular function remain elusive. Here, we compared continuation of common VA ECLS via femoral access with a transvenous implantation technique of a temporary right heart bypass (RHB) for patients undergoing LVAD implantation after dual mechanical support.