Mechanical circulatory support: Technical tips for the implantation of a right ventricular assist device
Evgenij Potapov, Christoph Starck, Volkmar Falk, Jaime‐Jürgen Eulert‐Grehn
Abstract
Small, implantable continuous-flow pumps were introduced into clinical practice in 1998. Due to the limited availability and complexity of total artificial hearts (TAHs), these systems are almost exclusively used for patients in emergency settings with no other support option. As a result, there is a growing need for a continuous-flow biventricular assist device (cfBIVAD). Left ventricular assist device (LVAD) pumps, which were developed for supporting the systemic circulation, can also assist the right ventricle (RV). Up to now, no commercially available implantable device is approved by the Food and Drug Administration or the European Medicines Agency for RV support, neither as isolated support of the RV nor in a biventricular mode. At the same time, the only commercially available device in the United States, the paracoroporeal Thoratec (Abbott Cardiovascular, Abbott Park, Ill) RV assist device (RVAD), has not been available for quite some time. The alternative is cardiectomy and implantation of the SynCardia (SynCardia Systems, Tucson, Ariz) TAH device or the Aeson TAH (Carmat, V elizy-Villacoubay, France) device, which are both approved by the European Medicines Agency.