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Munch F.,Universitatsklinikum Erlangen Nurnberg | Kasten W.,Universitatsklinikum Erlangen Nurnberg | Demuth M.,Universitatsklinikum Erlangen Nurnberg | Ihlenburg S.,Universitatsklinikum Erlangen Nurnberg Frank Munch | And 5 more authors.
Kardiotechnik | Year: 2010

Objective: Drug-resistant biventricular heart failure is commonly treated with a mechanical circulatory support system. However, testing of right ventricular performance in order to wean from biventricular assist device (BiVAD) is indeterminate. An 11-year old boy presented with severe cardiac and multiorgan failure. Echocardiography showed biventricular low cardiac output with right atrial thrombus formation. The patient was treated with operative thrombectomy, and ECMO. After six days, a BiVAD, Berlin-Heart EXCOR® was implanted due to failing recovery. After 90 days of mechanical support and biventricular recovery on ECHO cardiac weaning from BiVAD was discussed. On basis of the Berlin Heart weaning protocol, solely testing of left ventricular performance is possible. However, our concern pertained on right ventricular performance. We developed a weaning protocol in order to evaluate left and right ventricular function selectively. Over one week, the patient was consecutively weaned to a support rate of 30 bpm, BiVAD was explanted successfully, and the patient was sent home one week postoperatively. At the half year follow-up, the patient is still presenting with good biventricular cardiac function on echo. Selective evaluation of right and left ventricular function during BiVAD support is possible. Unclear remains the optimal timing for weaning from mechanical support.

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