Univentricular support results in reduction of pulmonary resistance and improved right ventricular function

A retrospective analysis was performed to assess the effects of univentricular support on the transpulmonary gradient (TPG), pulmonary vascular resistance (PVR), total pulmonary resistance (TPR), and right ventricular ejection fraction (RVEF) in 16 patients who spent from 2 to 144 days (mean, 61) on the Novacor left ventricular assist system ([LVAS] Novacor Corp., Baxter Healthcare, Oakland, CA) as a bridge to cardiac transplantation. Results revealed a significant reduction in the TPR, and improvement in RVEF while patients were on the LVAS. After orthotopic heart transplantation (OHTx), TPG and PVR were significantly lower than when calculated before support. It was concluded, therefore, that the reduction in the TPR and the improvement in the RVEF, seen in patients who were provided univentricular support with the Novacor LVAS, are associated with a significant reduction in the TPG and the PVR, which are persistent after OHTx. Four patients who otherwise would have been considered at higher risk for OHTx because of elevated pulmonary resistance before veniventricular support underwent successful OHTx after LVAS support.