Zusammenfassung
Besonders nach orthotoper Herztransplantation besteht ein Risiko eines postoperativen Rechtsherzversagens. Eine der therapeutischen Optionen ist die passagere Implantation eines mechanischen Unterstützungssystems des rechten ventrikels. Wir berichten über den Einsatz einer Kreiselpumpe unter einer solchen Indikation, welche nach einer Unterstützungszeit von 56 Stunden erfolgreich explantier werden konnte. Weiterhin diskutieren wir Methoden der mechanischen Unterstützung des rechten Herzens, deren Implantationstechniken und Risiken.
Summary
Postoperative right heart failure represents a well known, often lethal complication after orthotopic cardiac transplantation. Mechanical support of the right heart is one of the therapeutic options in this setting. We present the successful use of a centrifugal pump. After a duration of assist of 56 hours restoration of function of the transplanted right heart was achieved and the device could be explanted without further complications. Methods of right ventricular assist, techniques of implantation as well as possible risks are discussed.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Bolman RM III, Spray T, Cox JL (1987) Heart transplantation in patients requiring preoperative mechanical support. J Heart Lung Transplant 6: 273–280
Delius RE, Bove EL, Meliones JN, Custer JR, Moler FW, Crowley D, Amirikia A, Behrendt DM, Bartlett RH (1992) Use of extracorporeal life support in patients with congenital heart disease. Crit Care Med 20: 1216–1222
Kaye MP (1992) The registry of the International Society for Heart and Lung Transplantation: Ninth official report-1992. J Heart Lung Trans 11: 599–606
Maccioli GA, Lucas WJ, Norfleet EA (1988) the intra-aortic balloon pump: A review J Cardiothorac Anesth 2: 365–373
Pennock JL, Pierce WS, Campbell DB, Pae WE, Davis D, Henslay FA, Richenbacher WE, Waldhausen JA (1986) Mechanical support of the circulation fellowed by cardiac transplantation. J Thorac Cardiovasc Surg 92: 994–1004
Piffare R, Sullivan H, Montoya A, Bakhos M, Grieco J, Foy BK, Blakeman B, Constanzo-Nordin MR, Altergott R, Lonchyna V, Calandra D, Hinkampp T, Grady KL, Bartlett L (1992) Comparison of Results after Heart Transplantation: Mechanically Supported versus Nonsupported Patients. J Heart Lung Transplant 1992 11: 235–239
Rich S, Kaufmann E, Levy PS (1992) The effect of high dosis of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med 327: 76–81
Schoen FJ, Palmer DC, Bernhard WF, Pennington DG, Haudenschild CC, Ratliff NB, Berger RL, Golging LR, Watson JT (1986) Clinical temporary ventricular assist. J Thorac Cardiovasc Surg 92: 1071–1081
Stevenson LW (1993) Selection and management of patients for cardiac transplantation. Current Opinion in Cardiology 8: 411–418
Vincent JL, Carlier E, Pinsky MR, Goldstein J, Narije R, Lejeune P, Brimioulle S, Leclerc JL, Kahn RJ, Primo G (1992) Prostagladin E1 infusion for right ventricular failure after cardiac transplantation. J Thorac Cardiovasc Surg 103: 33–39
Wahlers T, Beer C, Fieguth HG, Cremer J, Jurmann M, Schäfers HJ, Hermann G, Frimpong K, Haverich A, Borst HG (1992) Right heart failure following orthotopic cardiac transplantation. Clin Transplantation 2: 252–256
Bittner H, Kendall S, Chen E, Davis R, Van Trigt P (1995) Right ventricular dysfunction in the brain-dead heart-beating organ donor. Transplant Proc Aug 27 (4): 2551–2555
Van Trigt P, Bittner HB, Kendall SW, Milano CA (1995) Mechanisms of transplant right ventricular dysfunction. Ann Surg Jun 221 (6): 666–675
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kondruweit, M., Weyand, M., Pier, T. et al. Erfolgreiche Behandlung eines Rechtsherzversagens nach Herztransplantation durch Einsatz einer Zentrifugalpumpe. Z. Herz-, Thorax-, Gefäßchir. 11, 94–99 (1997). https://doi.org/10.1007/BF03042631
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03042631