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Intravenous prostacyclins for right ventricular failure following left ventricular assist device in paediatric heart

Laura J Radel1, Mehreen Iqbal1, Megan Griffiths1

  • 1Division of Cardiology, Department of Paediatrics, University of Texas Southwestern, Dallas, TX, USA.

Cardiology in the Young
|June 29, 2023
PubMed

Insights

Right ventricular failure in children receiving a left ventricular assist device can be fatal. Intravenous prostacyclin successfully supported these patients, suggesting its potential as a key treatment for this complication.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Pulmonary Hypertension

Background:

  • Right ventricular failure (RVF) is a significant complication following left ventricular assist device (LVAD) implantation in pediatric heart failure.
  • RVF in this context is associated with increased mortality.
  • Pulmonary hypertension (PH) often accompanies RVF after LVAD placement.

Purpose of the Study:

  • To report the successful use of intravenous prostacyclin in a pediatric patient experiencing RVF and PH post-LVAD implantation.
  • To evaluate prostacyclin as a therapeutic option for RVF in the setting of LVAD support.

Main Methods:

  • Case report of a pediatric patient with heart failure requiring LVAD support.
  • Initiation of intravenous prostacyclin therapy for RVF and PH.
  • Monitoring of right ventricular function and pulmonary artery pressures.

Main Results:

  • Successful right ventricular support was achieved with intravenous prostacyclin.
  • Pulmonary hypertension was effectively managed.
  • The patient demonstrated improved hemodynamic stability post-intervention.

Conclusions:

  • Intravenous prostacyclin can be a valuable therapeutic strategy for managing right ventricular failure and pulmonary hypertension after LVAD implantation in pediatric patients.
  • This approach may improve outcomes in a high-risk population.

Keywords:
Left ventricular assist devicepaediatric heart failureprostacyclinpulmonary hypertensionright heart failure

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