Supporting the right ventricle in postcardiotomy renal dysfunction: A case series

Area of Science:

• Cardiology
• Nephrology
• Medical Devices

Background:

• Postcardiotomy right ventricular (RV) dysfunction is a known complication following cardiac surgery.
• This dysfunction can lead to elevated central venous pressure and subsequent congestive nephropathy, contributing to acute kidney injury (AKI).

Observation:

• Acute kidney injury (AKI) is frequently observed in patients with postcardiotomy RV dysfunction.
• Elevated central venous pressure due to RV dysfunction impairs renal perfusion and function.

Findings:

• Percutaneous insertion of a right ventricular assist device (RVAD) effectively augments cardiac output.
• RVAD insertion reduces central venous hypertension and alleviates congestive nephropathy.

Implications:

• Percutaneous RVADs offer a potential therapeutic strategy for managing AKI in the context of RV dysfunction.
• In select patients, RVADs may improve renal function and reduce the need for renal replacement therapy, such as dialysis.