Temporary Right-Ventricular Assist Devices: A Systematic Review.
Mahmoud AbdelshafyKadir CaliskanGöksel GüvenAhmed ElkoumyHagar ElsherbiniHesham ElzomourErhan TenekeciogluSakir AkinJuan Carlos ParodiPublished in: Journal of clinical medicine (2022)
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.
Keyphrases
- heart failure
- acute kidney injury
- atrial fibrillation
- randomized controlled trial
- early onset
- systematic review
- liver failure
- drug induced
- palliative care
- open label
- cardiac surgery
- oxidative stress
- left ventricular
- electronic health record
- cardiovascular disease
- coronary artery disease
- climate change
- quality improvement
- hepatitis b virus
- machine learning
- phase ii
- phase iii
- human health
- study protocol
- big data
- aortic dissection
- solid state