Application of Right Ventricular Assist Device for the Difficult Weaning off the Cardiopulmonary Bypass Due to the Pulmonary Hypertension

Chengbin Zhou, Min Wu, Jinsong Huang, Xiaohua Zhang, Jimei Chen, Jian Zhuang

Guangdong General Hospital, Guangzhou, China

Date, time and location: 2018.05.27 10:30, Congress Hall, 2F–A

Abstract

Objective: To summarize the experiences of right ventricular assist device (RVAD) for the difficult weaning off cardiopulmonary bypass due to the pulmonary artery (PH).

Methods: From October 2016 to July 2017, the rotaflow centrifugal pump was used as RVAD in five patients. The mean age was 41 ± 4.8 years and the mean weight was 58 ± 9.0 kg. Four patients underwent heart transplantation and one adult patient received atrial septal defect repair. The mean pulmonary arterial pressure was 57 ± 8.4 mmHg at the end of cardiopulmonary bypass. The patients couldn't wean off cardiopulmonary bypass even the high dose of PH-specific drugs were used. An 8 mm artificial blood vessel was sutured with pulmonary artery. Femoral venous cannula 24F was percutaneous inserted into right femoral vein and its tip to the right atrium. The femoral venous cannula drained the blood out of the body and then through the centrifugal pump and flow into the pulmonary artery via the artificial blood vessel. All patients can successfully wean off cardiopulmonary bypass after the installation of RVAD.

Results: The mean cardiopulmonary bypass time was 238 ± 42 min and the mean aortic cross-clamping time was 95 ± 47 min. The mean maximum flow rate of RVAD was 3.88 ± 0.19 L/min and the mean assist time was 163 ± 53 h. Remodulin was applied during the RVAD support. The mean extubation time was 12 ± 1.4 h after the operation. The mean pulmonary artery pressure was 34.5 ± 1.0 mmHg when leave the RVAD. Four patients with heart transplantation were discharged. One patient died of hypoxia, infection and multiple organ failure.

Conclusions: RVAD could overcome the pulmonary artery pressure and drive the right heart blood into the pulmonary circulation so that weaning off cardiopulmonary bypass could be possible.