Implantation of the Biomedicus centrifugal pump in post-transplant right heart failure

Background Right heart failure after heart transplantation represents a lif e-threatening complication. When conventional therapy including NO-inhalati on fails the only choice to reach sufficient haemodynamic conditions may be the implantation of a right ventricular support system. Methods. In all cases the Biomedicus centrifugal pump was implanted by cann ulation of the right atrium and pulmonary artery. Results, Since March 1989 950 heart transplant procedures were performed at our center. In nine cases (7 male, 2 female, mean age 52 years) implantati on of a right ventricular support system was necessary because of deteriora tion of right ventricular function. The implantation was carried out in 7 c ases immediately after transplantation, in 2 cases after 2 days. The suppor t time ranged from 4-348 hours. Six patients could be weaned, 2 patients un derwent retransplantation and died and 1 patient died on the support system . Three of the six weaned patients died in the further course because of mu ltiorgan failure. Conclusions, Mechanical right ventricular support is often the only therape utical tool to reach adequate haemodynamic conditions In post-transplant ri ght heart failure. The Biomedicus centrifugal pump provides good conditions in these cases. Weaning is often possible after short-term support. The mo rtality rate is determined by multiorgan failure in immune-suppressed patie nts. Retransplantation seems not to be successful despite maximal treatment .