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Ann Thorac Surg 1986;41:606-608
© 1986 The Society of Thoracic Surgeons

Articles

A Rational Approach to the Selection of an Assist Device for the Failing Right Ventricle

Paul A. Spence, M.D., Charles M. Peniston, M.D., Niko Mihic, M.D., A. Karim Jabr, C.P., Tomas A. Salerno, M.D.*

Division of Cardiovascular Surgery, St. Michael's Hospital, and the University of Toronto, Toronto, Ontario, Canada

Accepted for publication August 5, 1985.

* Address reprint requests to Dr. Salerno, St. Michael's Hospital, 30 Bond St., Toronto, Ontario, Canada M5B 1W8


   Abstract
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 Abstract
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Assist devices have become available for the treatment of right ventricular (RV) failure. The present study assesses the efficacy of pulmonary artery balloon counterpulsation (PABC) in restoring RV output to normal levels. In a porcine model of RV failure during left heart bypass, PABC restored RV output to normal, provided that the RV output was not depressed to less than 50% of baseline values. When RV failure was more severe, PABC was not effective in restoring RV output to base line. This study suggests that a rational approach should be developed for the use of right heart assist devices. In moderately severe RV failure, PABC may be successful in restoring cardiac output to normal. However, in extreme failure a right heart bypass is necessary.


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Supported by grants from the Medical Research Council of Canada and the Heart and Stroke Foundation of Ontario.


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  1. Pierce WS, Parr GVS, Myers JL, et al. Ventricular-assist pumping in patients with cardiogenic shock after cardiac operations N Engl J Med 1981;305:160616.[Medline]
  2. Pennock JL, Pierce WS, Wisman CB, et al. Survival and complications following ventricular assist pumping for cardiogenic shock Ann Surg 1983;198:469.[Medline]
  3. Pennington DG, Merjavy JP, Swartz MT, et al. The importance of biventricular failure in patients with postoperative cardiogenic shock Ann Thorac Surg 1985;39:16.[Abstract/Free Full Text]
  4. Miller DC, Moreno-Cabral RJ, Stinson EB, et al. Pulmonary artery balloon counterpulsation for acute right ventricular failure J Thorac Cardiovasc Surg 1980;80:760.[Abstract]
  5. Flege JB, Wright CB, Reisinger TJ. Successful balloon counterpulsation for right ventricular failure Ann Thorac Surg 1984;37:167.[Abstract/Free Full Text]
  6. Moran JM, Opravil M, Gorman AJ, et al. Pulmonary artery balloon counterpulsation for right ventricular failure: II. Clinical experience Ann Thorac Surg 1984;38:254.[Abstract/Free Full Text]
  7. Symbas PN, KcKeown PP, Santora AH, Vlasis SE. Pulmonary artery balloon counterpulsation for treatment of intraoperative right ventricular failure Ann Thorac Surg 1985;39:437.[Abstract/Free Full Text]
  8. Gaines WE, Pierce WS, Prophet GA, Holtzman K. Pulmonary circulatory support: a quantitative comparison of four methods J Thorac Cardiovasc Surg 1984;88:958.[Abstract]
  9. Opravil M, Gorman AJ, Krejcie TC, et al. Pulmonary artery balloon counterpulsation for right ventricular failure: I. Experimental results Ann Thorac Surg 1984;38:242.[Abstract/Free Full Text]
  10. Jett GK, Siwek LG, Picone AL, et al. Pulmonary artery balloon counterpulsation for right ventricular failure J Thorac Cardiovasc Surg 1983;86:364.[Abstract]
  11. Spence PA, Weisel RD, Easdown J, et al. The hemodynamic effects and mechanism of action of pulmonary artery balloon counterpulsation in the treatment of right ventricular failure during left heart bypass Ann Thorac Surg 1985;39:329.[Abstract/Free Full Text]
  12. Spence PA, Weisel RD, Easdown J, et al. Pulmonary artery balloon counterpulsation in the management of right ventricular failure during left heart bypass J Thorac Cardiovasc Surg 1985;89:264.[Abstract]
  13. Duncan DB. Multiple range amd multiple F tests Biometrics 1955;2:2.



This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
P. D. Skillington, G. S. Couper, P. S. Peigh, D. Fitzgerald, and L. H. Cohn
Pulmonary artery balloon counterpulsation for intraoperative right ventricular failure
Ann. Thorac. Surg., April 1, 1991; 51(4): 658 - 660.
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