Temporary Right-Ventricular Assist Devices: A Systematic Review


Abdelshafy M., Caliskan K., Guven G., Elkoumy A., Elsherbini H., Elzomor H., ...More

JOURNAL OF CLINICAL MEDICINE, vol.11, no.3, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.3390/jcm11030613
  • Journal Name: JOURNAL OF CLINICAL MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Keywords: right-sided heart failure, temporary right ventricular assist device, safety, efficacy, systematic review, MECHANICAL CIRCULATORY SUPPORT, RIGHT HEART-FAILURE, CENTRIFUGAL PUMP, IMPLANTATION, MANAGEMENT, OUTCOMES, DYSFUNCTION, RECOVERY, CANNULA
  • Hacettepe University Affiliated: No

Abstract

Acute right-sided heart failure (RHF) is a complex clinical syndrome, with a wide range of clinical presentations, associated with increased mortality and morbidity, but about which there is a scarcity of evidence-based literature. A temporary right-ventricular assist device (t-RVAD) is a potential treatment option for selected patients with severe right-ventricular dysfunction as a bridge-to-recovery or as a permanent solution. We sought to conduct a systematic review to determine the safety and efficacy of t-RVAD implantation. Thirty-one studies met the inclusion criteria, from which data were extracted. Successful t-RVAD weaning ranged between 23% and 100%. Moreover, 30-day survival post-temporary RAVD implantation ranged from 46% to 100%. Bleeding, acute kidney injury, stroke, and device malfunction were the most commonly reported complications. Notwithstanding this, t-RVAD is a lifesaving option for patients with severe RHF, but the evidence stems from small non-randomized heterogeneous studies utilizing a variety of devices. Both the etiology of RHF and time of intervention might play a major role in determining the t-RVAD outcome. Standardized endpoints definitions, design and methodology for t-RVAD trials is needed. Furthermore, efforts should continue in improving the technology as well as improving the timely provision of a t-RVAD.