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Вестник трансплантологии и искусственных органов

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МЕХАНИЗМЫ ПРАВОЖЕЛУДОЧКОВОЙ НЕДОСТАТОЧНОСТИ В УСЛОВИЯХ ЛЕВОЖЕЛУДОЧКОВОГО ВСПОМОГАТЕЛЬНОГО КРОВООБРАЩЕНИЯ И МЕТОДЫ БИВЕНТРИКУЛЯРНОГО ОБХОДА СЕРДЦА

https://doi.org/10.15825/1995-1191-2013-4-126-137

Аннотация

В статье приведен обзор литертуры, посвященный проблемам механической поддержки кровооб- ращения с помощью левожелудочкового обхода в условиях тотальной сердечной недостаточности. Дисфункция правого желудочка во многом определяет высокую летальность при левожелудочковом обходе. Одним из эффективных методов решения данной проблемы является применение устройств для правожелудочкового обхода. Рассмотрены основные физиологические механизмы взаимодейс- твия правого и левого желудочков сердца, влияющие на функцию правых отделов сердца. Показана необходимость оценки функции правого желудочка до принятия решения о механической поддержке кровообращения. Приведены примеры определения предикторов развития правожелудочковой недо- статочности. Рассмотрены основные методы и устройства бивентрикулярной поддержки кровообра- щения. 

Об авторах

Г. П. Иткин
Лаборатория биотехнических систем (зав. – д. б. н., проф. Г.П. Иткин) ФГБУ «Федеральный научный центр трансплантологии и искусственных органов им. акад. В.И. Шумакова» Минздрава России (директор – академик РАМН, проф. С.В. Готье), Москва, Российская Федерация


В. Н. Попцов
Отдел анестезиологии, реанимации и интенсивной терапии (зав. – проф. В.Н. Попцов) ФГБУ «Федеральный научный центр трансплантологии и искусственных органов им. акад. В.И. Шумакова» Минздрава России (директор – академик РАМН, проф. С.В. Готье), Москва, Российская Федерация


Список литературы

1. СПИСОК ЛИТЕРАТУРЫ

2. Kirklin J.K., Naftel D.C., Kormos R.L., Stevenson L.W., Pagani F.D., Miller M.A., Baldwin J.T., Young J.B. The Fourth INTERMACS Annual Report: 4,000 implants and counting. J. Heart Lung Transplant. 2012; 31: 117– 126.

3. Goldstein D.J., Oz M.C., Rose E.A. Implantable left ventri- cular assist devices. N. Engl. J. Med. 1998; 339: 1522–1533.

4. Van Meter C.H. Right heart failure: best treated by avoid- ance. Ann. Thorac. Surg. 2001; 71 (l): 220–222.

5. Pavie A., Leger P. Physiology of univentricular versus biventricular support. Ann. Thorac. Surg. 1996; 61: 347– 349.

6. Mandarino W.A., Winowich S., Gorcsan III J., Gasi- or T.A., Pham M., Griffith B.P., Kormos R.L. Right ven- tricular performance and left ventricular assist device filling. Ann. Thorac. Surg. 1997; 63: 1044–1049.

7. Farrar D.J., Compton P.G., Hershon J.J., Hill J.D. Right ventricular function in an operating room model of me- chanical left ventricular assistance and its effects in pa- tients with depressed left ventricular function. Circula- tion. 1985; 72: 1279–1285.

8. Kucuker S.A., Stetson S.J., Becker K.A., Akgül A., Loe- be M., Lafuente J.A., Noon G.P., Koerner M.M., Ent- man M.L., Torre-Amione G. Evidence of improved right ventricular structure after LVAD support in patients with end-stage cardiomyopathy. J. Heart Lung Transplant. 2004; 23 (1): 28–35.

9. Карро К., Педли Т., Шротер Р., Сид У. Механика кровообращения. Москва: Мир, 1981 (Сaro C.G., Ped- ley T.J., Schroter R.C., Seed W.A. The mechanics of the circulation. Oxford. Oxford University Press, New York Toronto 1978).

10. Mandarino W.A., Morita S., Kormos R.L., Kawai A., De- neault L.G., Gasior T.A., Losken B., Griffith B.P. Quan- titation of right ventricular shape change after left ven- tricular assist device implantation. ASAIO J. 1992; 38: M228–M231.

11. Feneley M.P., Cavaghan T.P., Baron D.W., Roy P.R., Morgan J.J. Contribution of left ventricular contraction to the generation of right ventricular systolic pressure in human heart. Circulation. 1985; 71: 473–480.

12. Furukawa K., Motomura T., Nosé Y. Right ventricular failure after left ventricular assist device implantation: the need for an implantable right ventricular assist de- vice. Artif. Organs. 2005; 29: 369–377.

13. Reesink K., Dekker A., van der Nagel T., Blom H., Soemers C., Geskes G., Maessen J., van der Veen E. Physiologicinsensitive left ventricular assist predis- poses right-sided circulatory failure: a pilot simula- tion and validation study. Artif. Organs. 2004; 28 (10): 933–939.

14. Dang N.C., Topkara V.K., Mercando M., Kay J., Kru- ger K.H., Aboodi M.S., Oz M.C., Naka Y. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J. Heart Lung Transplant. 2006; 25: 1–6.

15. Santambrogio L., Bianchi T., Fuardo M., Gazzoli Ve- ronesi R., Braschi A., Maurelli M. Physiologicinsen- sitive left ventricular assist predisposes right-sided circulatory failure: a pilot simulation and validation study. Interact. Cardiovasc. Thorac. Surg. 2006; 5 (4): 379–382.

16. Potapov Е.V., Loforte A., Weng Y., Jurmann M., Pa- sic M., Drews T., Loebe M., Hennig E., Krabatsch T., Koster A., Lehmkuhl H.B., Hetzer R. Experience with over 1000 implanted ventricular assist devices. J. Card. Surg. 2008; 23 (3): 185–194.

17. Deng M.C., Edwards L., Hertz M.I., Rowe A.W., Keck B.M., Kormos R., Naftel D.C., Kirklin J.K., Tay- lor D.O. Mechanical circulatory support device database of the International Society for Heart and Lung Trans- plantation: third annual report–2005. J. Heart Lung Transplant. 2005; 24 (9): 1182–1187.

18. Morgan J.A., John R., Lee B.J., Oz M.C., Naka Y. Is severe right ventricular failure in left ventricular assist device recipients a risk factor for unsuccessful bridging to transplant and post-transplant mortality? Ann. Thorac. Surg. 2004; 77: 859–863.

19. Kavarana M.N., Pessin-Minsley M.S., Urtecho J., Cat- anese K.A., Flannery M., Oz M.C., Naka Y. Right ven- tricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem. Ann. Tho- rac. Surg. 2002; 73: 745–750.

20. Kormos R.L., Gasior T.A., Kawai A., Pham S.M., Mu- rali S., Hattler B.G., Griffith B.P. Transplant candidate’s clinical status rather than right ventricular function de- fines need for univentricular versus biventricular sup- port. J. Thorac. Cardiovasc. Surg. 1996; 111 (4): 773– 783.

21. Dang, N.C., Mercando M.L., Kay J., Topkara V.K., Kru- ger K.H., Aboodi M.S., Martens T.P., George I., Chee- ma F.H., Oz M.C., Naka Y. Right heart failure following left ventricular assist device implantation. J. Heart Lung Transplant. Abstracts 2005; 24: s147.

22. Lahm T., McCaslin C.A.,Wozniak T.C., Ghumman W., Fadl Y.Y., Obeidat O.S., Schwab K., Meldrum D.R. Medical and surgical treatment of acute right ven- tricular failure. J. Am. Coll. Cardiol. 2010; 56 (18): 1435–1446.

23. Santambrogio L., Bianchi T., Fuardo M, Gazzoli F., Ve- ronesi R., Braschi A., Maurelli M. Right ventricular fail- ure after left ventricular assist device insertion: preop- erative risk factors. Interact. Cardiovasc. Thorac. Surg. 2006; 5: 379–382.

24. Ochiai Y., McCarthy P.M., Smedira N.G., Banbury M.K., Navia J.L., Feng J., Hsu A.P., Yeager M.L., Buda T., Ho- ercher K.J., Howard M.W., Takagaki M., Doi K., Fuka- machi K. Predictors of severe right ventricular failure after implantable left ventricular assist device insertion: analysis of 245 patients. Circulation 2002; 106 (12 Sup- pl 1): 198–202.

25. Fukamachi K., McCarthy P.M., Smedira N.G., Var- go R.L., Starling R.C., Young J.B. Preoperative risk fac- tors for right ventricular failure after implantable left ventricular assist device insertion. Ann. Thorac. Surg. 1999; 68 (6): 2181–2184.

26. Farrar D.J., Hill J.D., Pennington D.G., McBride L.R., Holman W.L., Kormos R.L., Esmore D., Gray L.A., Seif- ert P.E., Schoettle G.P., Moore C.H., Hendry P.J., Bhay- ana J.N. Preoperative and postoperative comparison of patients with univentricular and biventricular support with the Thoratec ventricular assist device as a bridge to cardiac transplantation. J. Thorac. Cardiovasc. Surg. 1997; 113 (1): 202–209.

27. Chen J.M., Levin H.R., Rose E.A., Addonizio L.J., Landry D.W., Sistino J.J., Michler R.E., Оz M.C. Experi- ence with right ventricular assist devices for perioperative right-sided circulatory failure. Ann. Thorac. Surg.

28. ; 61: 305–310.

29. Schenk S., McCarthy P.M., Feng J., Hoercher K.J.,

30. Starling R.C., Young J.B., Zhou L., Navia J.L., Black- stone E.H., Fukamachi K. Right ventricular stroke work index (RVSWI) predicts duration of inotropic support after left ventricular assist device implantation. J. Heart Lung Transplant. 2004: S108.

31. McCarthy P.M., Smedira N.G. Implantable LVAD in- sertion in patients with previous heart surgery. J. Heart Lung Transplant. 2000; 19 (l): S95–S100,

32. Ramakrishna H. Recent advances in pulmonary hyper- tension therapy. Recent Pat Cardiovasc. Drug Discov. 2008; 3: 28–36.

33. Kirklin J.K., Young J.B., McGiffin D.C. Recipient evalu- ation and selection, in Heart Transplantation. Philadel- phia, Churchill Livingstone. 2002: 210–211.

34. Potapov E.V., Stepanenko A., Dandel M., Kukucka M., Lehmkuhl H., Weng Y., Hennig F., Krabatsch T., Het- zer R. Tricuspid incompetence and geometry of the right ventricle are predictors of right ventricular function after implantation of a left ventricular assist device. J. Heart Lung Transplant. 2008; 27 (12): 1275–1281.

35. Fitzpatrick III J.R., Frederick J.R., Hsu V.M., Kozin E.D., O’Hara M.L., Howell E., Dougherty D., McCor- mick R.C., Laporte C.A., Cohen J.E., Southerland K.W., Howard J.L., Jessup M.L., Morris R.J., Acker M.A., Woo Y.J. Risk Score Derived from Pre-operative Data Analysis Predicts the Need for Biventricular Mechani- cal Circulatory Support. J. Heart Lung Transplant. 2008; 27: 1286–1292.

36. Magliato K.E., Kleisli T., Soukiasian H.J., Tabrizi R., Coleman B., Hickey A., Czer L.S., Blanche C., Cheng W., Fontana G.P., Kass R.M., Raissi S.S., Trento A. Biven- tricular support in patients with profound cardiogenic shock: a single center experience. ASAIO J. 2003; 49 (4): 475–479.

37. Tsukui H., Teuteberg J.J., Murali S., McNamara D.M., Buchanan J.R., Winowich S., Stanford E., Mathier M.A., Cadaret L.M., Kormos R.L. Biventricular assist device utilization for patients with morbid congestive heart failure: a justifiable strategy. Circulation. 2005; 112 (I): 165–172.

38. Matthews J.C., Koelling T.M., Pagani F.D., Aaron- son K.D. The right ventricular failure risk score a pre- operative tool for assessing the risk of right ventricular failure in left ventricular assist device candidates. J. Am. Coll Cardiol. 2008; 51: 2163–2172.

39. Drakos S.G., Janicki L., Horne B.D., Kfoury A.G., Reid B.B., Clayson S., Horton K., Haddad F., Li D.Y., Renlund D.G., Fisher P.W. Risk factors predictive of right ventricular failure after left ventricular assist de- vice implantation. Am. J. Cardiol. 2010; 105 (7): 1030– 1035.

40. Loforte A., Stepanenko A., Potapov E.V., Musumeci F., Dranishnikov N., Schweiger M., Montalto A., Pasic M., Weng Y., Dandel M., Siniawski H., Kukucka M., Kra- batsch T., Hetzer R. Temporary Right Ventricular Me- chanical Support in High-Risk Left Ventricular Assist Device Recipients Versus Permanent Biventricular or Total Artificial Heart Support. Artificial Organs. 2013,

41. (6): 523–530.

42. Saito S., Sakaguchi T., Miyagawa S., Nishi H., Yoshi-

43. kawa Y., Fukushima S., Daimon T., Sawa Y. Recovery of right heart function with temporary right ventricular assist using a centrifugal pump in patients with severe bi- ventricular failure. J. Heart Lung Transplant. 2012; 31: 858–864.

44. Klotz S., Naka Y., Oz M.C., Burkhoff D. Biventricular as- sist device – induced right ventricular reverse structural and functional remodeling. J. Heart Lung Transplant. 2005; 24: 1195–2201.

45. Кrabatsch T., Stepanenko A., Schweiger M., Kukuc- ka M., Ewert P., Hetzer R., Potapov E. Alternative Tech- nique for Implantation of Biventricular Support with HeartWare Implantable Continuous Flow Pump. ASAIO J. 2011; 57: 333–335.

46. Saed D., Oonaki Y., Akiyama M., Horai T., Catanese J., Fumoto H., Dessoffy R., Massiello A.L., Horvath D.J., Zhou Q., Chen J., Benefit S., Golding L.A.R., Fukama- chi K. Acute in vivo Evaluation of an Implantable Con- tinuous Flow Biventricular Assist System. ASAIO J. 2008; 54: 20–24.

47. Po-Lin Hsu P-L., Parke J., Egger C., Autschbach R., Schmitz-Rode T., Steinseifer U. Mechanical Circula- tory Support for Right Heart Failure: Current Techno- logy and Future Outlook. Artificial Organs. 2012, 36 (4): 332–347.

48. Khani-HanjaniA.,LoorG.,ChamogeorgakisT.,ShafiiA., Mountis M., Hanna M., Soltesz E., Gonzalez-Stainski G.V. Case Series Using the ROTAFLOW System as a Tempo- rary Right Ventricular Assist Device after HeartMate II Implantation. ASAIO J. 2013; 59: 456–460.


Для цитирования:


Иткин Г.П., Попцов В.Н. МЕХАНИЗМЫ ПРАВОЖЕЛУДОЧКОВОЙ НЕДОСТАТОЧНОСТИ В УСЛОВИЯХ ЛЕВОЖЕЛУДОЧКОВОГО ВСПОМОГАТЕЛЬНОГО КРОВООБРАЩЕНИЯ И МЕТОДЫ БИВЕНТРИКУЛЯРНОГО ОБХОДА СЕРДЦА. Вестник трансплантологии и искусственных органов. 2013;15(4):126-137. https://doi.org/10.15825/1995-1191-2013-4-126-137

For citation:


Itkin G.P., Poptsov V.N. MECHANISMS OF RIGHT VENTRICULAR FAILURE AND BIVENTRICULAR MECHANICAL CIRCULATORY SUPPORT. Russian Journal of Transplantology and Artificial Organs. 2013;15(4):126-137. https://doi.org/10.15825/1995-1191-2013-4-126-137

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ISSN 1995-1191 (Print)
ISSN 2412-6160 (Online)