Right heart failure surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Surgical intervention in [[right heart failure]] is mainly indicated in valvular pathologies and congenital heart diseases that are causing worsening of [[heart failure]] despite adequate medical interventions. In addition, early surgical interventions in these pathologies have been associated with improved survival and functional status (exercise tolerance for example which serves as an important prognostic indicator in right heart failure) of the patients. <ref name=”Haddad”>Haddad F. et al. Right Ventricular function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance and Management of Right Ventricular failure. Circulation. 2008;117:1717-1731</ref>. Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a [[lung transplant]] or heart-lung transplant can extend survival. | |||
==Surgery== | ==Surgery== | ||
Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a [[lung transplant]] or heart-lung transplant can extend survival. | * Surgical intervention in [[right heart failure]] is mainly indicated in valvular pathologies and congenital heart diseases that are causing worsening of [[heart failure]] despite adequate medical interventions.<ref name=”Haddad”>Haddad F. et al. Right Ventricular function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance and Management of Right Ventricular failure. Circulation. 2008;117:1717-1731</ref> | ||
*At advanced stages of [[heart failure]], the following surgical procedures have been adapted depending on the individual cases and of course the patient’s will: | |||
**Atrial septostomy in some patients with [[pulmonary hypertension]] | |||
**[[Heart]], heart-lung or double transplantation | |||
**Extracorporeal membrane oxygenation ECMO | |||
**Right [[ventricle]] / left [[ventricle]] assist devices.<ref name=”Haddad”>Haddad F. et al. Right Ventricular function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance and Management of Right Ventricular failure. Circulation. 2008;117:1717-1731</ref>. | |||
*The most common indications of a right ventricular assist device (RVAD) are: | |||
**Severe right ventricular failure after left ventricle assist device | |||
**Right ventricular failure after massive [[pulmonary embolism]] | |||
**Right ventricular failure after [[heart transplantation]]<ref name=”Haddad”>Haddad F. et al. Right Ventricular function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance and Management of Right Ventricular failure. Circulation. 2008;117:1717-1731</ref><ref>Kaul TK, Fields BL. Postoperative acute refractory right ventricular failure: incidence, pathogenesis, management and prognosis. Cardiovasc Surg. 2000;8:1-9.</ref> | |||
*Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a [[lung transplant]] or heart-lung transplant can extend survival. | |||
==References== | ==References== | ||
Revision as of 04:52, 19 November 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate editor-in-chief: Jad Z Al Danaf; Rim Halaby
Overview
Surgical intervention in right heart failure is mainly indicated in valvular pathologies and congenital heart diseases that are causing worsening of heart failure despite adequate medical interventions. In addition, early surgical interventions in these pathologies have been associated with improved survival and functional status (exercise tolerance for example which serves as an important prognostic indicator in right heart failure) of the patients. [1]. Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a lung transplant or heart-lung transplant can extend survival.
Surgery
- Surgical intervention in right heart failure is mainly indicated in valvular pathologies and congenital heart diseases that are causing worsening of heart failure despite adequate medical interventions.[1]
- At advanced stages of heart failure, the following surgical procedures have been adapted depending on the individual cases and of course the patient’s will:
- Atrial septostomy in some patients with pulmonary hypertension
- Heart, heart-lung or double transplantation
- Extracorporeal membrane oxygenation ECMO
- Right ventricle / left ventricle assist devices.[1].
- The most common indications of a right ventricular assist device (RVAD) are:
- Severe right ventricular failure after left ventricle assist device
- Right ventricular failure after massive pulmonary embolism
- Right ventricular failure after heart transplantation[1][2]
- Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a lung transplant or heart-lung transplant can extend survival.
References
- ↑ 1.0 1.1 1.2 1.3 Haddad F. et al. Right Ventricular function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance and Management of Right Ventricular failure. Circulation. 2008;117:1717-1731
- ↑ Kaul TK, Fields BL. Postoperative acute refractory right ventricular failure: incidence, pathogenesis, management and prognosis. Cardiovasc Surg. 2000;8:1-9.