• Shahrokh Taghavi, Andreas Zuckermann, Jan Ankersmit, Georg Wieselthaler, Angela Rajek, Günther Laufer, Ernst Wolner, and Michael Grimm.
• Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria. taghavis@hotmail.com
• Ann. Thorac. Surg. 2004 Nov 1;78(5):1644-9.

BackgroundAcute right ventricular failure after heart transplantation is a life-threatening condition, and sometimes the use of mechanical circulatory support is inevitable. The aim of this retrospective study was to investigate the effectiveness of two different mechanical circulatory support systems for this indication.MethodsFrom 1984 to 2003, 28 heart transplant recipients exhibited right ventricular failure resistant to drug therapy. Right ventricular assist device (n = 15) or extracorporeal membrane oxygenation (n = 13) was implanted to support the failing heart.ResultsOverall in-hospital survival was 43%. In the right ventricular assist device group, only 2 patients (13%) could be weaned from mechanical circulatory support compared with 10 patients (77%) in the extracorporeal membrane oxygenation group (p = 0.001). Retransplantation was necessary in 6 patients in the right ventricular assist device group and in 1 patient in the extracorporeal membrane oxygenation group (p = 0.049). There was no difference in patient survival between groups, but graft survival was significantly better in the extracorporeal membrane oxygenation group (p = 0.005).ConclusionsIn view of these results, extracorporeal membrane oxygenation seems to be the better option as mechanical circulatory support for right ventricular failure in heart transplantation.

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