Right heart failure surgery
|
Right heart failure Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Right heart failure surgery On the Web |
|
American Roentgen Ray Society Images of Right heart failure surgery |
|
Risk calculators and risk factors for Right heart failure surgery |
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.