A novel percutaneous mechanical biventricular bridge to recovery in severe cardiac allograft rejection

作者：Rajagopal Vivek^*; Steahr Gregg; Wilmer Charles I; Raval Nirav Y

来源：Journal of Heart and Lung Transplantation, 2010, 29(1): 93-95.

DOI：10.1016/j.healun.2009.09.015

• percutaneous
• biventricular support
• allograft rejection
• Impella 2.5
• TandemHeart

We describe the case of a 36-year-old man with acute cardiac transplant rejection bridged to recovery using simultaneous Impella 2.5 and TandemHeart percutaneous support devices. The patient underwent orthotopic cardiac transplantation 2 years earlier, and presented to our hospital with allograft failure 7 days after non-compliance with tacrolimus. Because of persistent cardiogenic shock despite intra-aortic balloon and inotropic support, we implanted an Impella 2.5 percutaneous assist device for left ventricular support. Persistent right ventricular dysfunction necessitated insertion of a TandemHeart for right ventricular support. After a course of intravenous solumedrol and anti-thymocyte globulin, both the Impella and TandemHeart devices were successfully weaned and removed. Nine months later, his left ventricular ejection fraction had stabilized from 10% to 55%.

• 出版日期2010-1