Sno

Characteristic

RVAD

LVAD

1

Principle

Decompresses the right ventricle and provides blood flow to pulmonary artery

Decompresses the left ventricle and provides blood flow to the aorta for systemic circulation

2

Cannulation

Inflow: Right atrium

Out flow: Main pulmonary artery

Inflow: apex of Left Ventricle (most common site)

Out flow: Ascending Aorta

3

Variables influencing the device function

Intravascular volume and left ventricle function

Intravascular volume, RV function

4

Scope of usage

Isolated RV failure is less frequently seen, mostly indicated in cases of RV failure post LVAD implantation and LV failure post cardiotomy period

Isolated LV dysfunction

5

Indications [22]

· Mean Right Atrial pressure > 20 mmHg

· Left Atrial pressure < 15 mmHg

· No Tricuspid Regurgitation

· In case of RV dysfunction post LVAD implantation when unable to maintain LVAD flow > 2.0 lit/min/m² with Right Atrial pressure > 20 mmHg

· Systolic blood pressure < 90 mmHg

· Left Atrial pressure > 20 mmHg

· Systemic Vascular Resistance > 2100 dynes/sec/cm⁻⁵

6

Management

· Flows to maintain systemic output 2.2 lit/min/m² with Left Atrial pressure 15 mmHg maintaining Right Atrial pressure of 5 - 10 mm Hg

· activated Partial Thromboplastin Time (aPTT): 2 - 2.5 times normal value, during weaning 2.5 - 3 times the normal value

· Activated Clotting Time (ACT): 180 - 200 seconds and during weaning 250 - 300 seconds

· Flows to maintain systemic output 2.2 lit/min/m² with Left Atrial pressure in the range of 10 - 15 mmHg

· aPTT: 2 - 2.5 times normal value, during weaning 2.5 - 3 times the normal value

· ACT: 180 - 200 seconds and during weaning 250 - 300 seconds