Right heart failure surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jad Z Al Danaf; Rim Halaby

Overview[edit | edit source]

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[edit | edit source]

• 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 transplantation, heart-lung 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[edit | edit source]

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