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J Thorac Cardiovasc Surg 2004;128:625-626
© 2004 The American Association for Thoracic Surgery
Brief communication |
a Department of Surgery, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, Tex, USA
Received for publication October 31, 2003; accepted for publication February 25, 2004.
* Address for reprints: O. H. Frazier, M.D., Texas Heart Institute, P. O. Box 20345, MC 3-147, Houston TX 77225-0345, USA
mmallia@heart.thi.tmc.edu
| The first 20% of the full text of this article appears below. |
After implantation of a left ventricular assist device (LVAD), right ventricular dysfunction and elevated peripheral vascular resistance may result in right ventricular failure and increased mortality. Right ventricular support may become necessary, as in the following case in which two Jarvik FlowMakers (Jarvik Heart, Inc, New York, NY) provided biventricular assistance.
Clinical summary
A 21-year-old man with end-stage idiopathic cardiomyopathy was referred to our hospital and approved for heart transplantation. He had a left ventricular ejection fraction lower than 20% with mitral and tricuspid regurgitation. Despite maximal medical therapy and balloon counterpulsation, LVAD support became necessary as a lifesaving measure. A Jarvik FlowMaker was implanted in the left ventricle through a midline sternotomy with outflow graft anastomosis to the ascending aorta.1 On postoperative day 1, the cardiac index increased by 60%, from 1.5 to 2.3 L/(min · m2). The patient was extubated on day 3. Two
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