{
    "abstract": "Post-implant right heart failure (RHF) has been recognized as a crucial prognostic factor in patients receiving left ventricular assist devices (LVADs), and its management has long attracted attention from cardiologists and surgeons.\nThis report described an 18-year-old female with acutely deteriorating heart failure due to dilated cardiomyopathy who underwent paracorporeal pulsatile-flow LVAD and developed early post-implant RHF. At postoperative day (POD) six, she was almost asymptomatic at rest on 2.5\u00a0mg/kg/min of dobutamine; however, the echocardiogram, performed as part of the daily postoperative care, revealed a severely enlarged right ventricle with a decompressed left ventricle, implying the development of post-implant RHF. Bolus infusion of saline and reduction of pump flow (6.0\u00a0L/min to 3.0\u00a0L/min) led to normalization of both ventricular shapes in 30\u00a0s, suggesting that RHF could be managed without surgical interventions. Milrinone was started on POD six, followed by sildenafil administration on POD seven. Fluid balance was strictly adjusted under the close observation of daily echocardiograms. Milrinone and dobutamine were discontinued on PODs 18 and 21, respectively. The patient was listed for a heart transplant on POD 40. Despite reduced right ventricular function (right ventricular stroke work index of 182.34 mmHg*ml/m\nIn post-implant RHF management, early detection, together with proper and prompt medical management, is crucial to avoiding any surgical intervention. Close observation of daily echocardiograms might be helpful in detecting subclinical RHF and is useful for post-implant medical management.",
    "authors": [
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.\nDepartment of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.\nDepartment of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.",
            "firstname": "Shingo",
            "initials": "S",
            "lastname": "Kunioka"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. oseguchi@ncvc.go.jp.",
            "firstname": "Osamu",
            "initials": "O",
            "lastname": "Seguchi"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Tasuku",
            "initials": "T",
            "lastname": "Hada"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Hiroki",
            "initials": "H",
            "lastname": "Mochizuki"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Masaya",
            "initials": "M",
            "lastname": "Shimojima"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Takuya",
            "initials": "T",
            "lastname": "Watanabe"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Yasumasa",
            "initials": "Y",
            "lastname": "Tsukamoto"
        },
        {
            "affiliation": "Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Naoki",
            "initials": "N",
            "lastname": "Tadokoro"
        },
        {
            "affiliation": "Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Satoshi",
            "initials": "S",
            "lastname": "Kainuma"
        },
        {
            "affiliation": "Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Satsuki",
            "initials": "S",
            "lastname": "Fukushima"
        },
        {
            "affiliation": "Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.",
            "firstname": "Tomoyuki",
            "initials": "T",
            "lastname": "Fujita"
        },
        {
            "affiliation": "Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.",
            "firstname": "Hiroyuki",
            "initials": "H",
            "lastname": "Kamiya"
        },
        {
            "affiliation": "Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. n-fukushima@cs.kinran.ac.jp.\nDepartment of Nursing, Senri Kinran University, Suita, Osaka, 565-0873, Japan. n-fukushima@cs.kinran.ac.jp.",
            "firstname": "Norihide",
            "initials": "N",
            "lastname": "Fukushima"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2023. BioMed Central Ltd., part of Springer Nature.",
    "doi": "10.1186/s13019-023-02368-1\n10.1016/j.healun.2020.03.010\n10.1016/j.bpa.2012.03.006\n10.1016/j.jacc.2008.03.009\n10.1016/j.jtcvs.2009.11.020\n10.1016/j.jtcvs.2008.09.021\n10.1016/j.athoracsur.2008.05.016\n10.1016/j.cardfail.2015.10.019\n10.1097/MAT.0b013e3182a816d1\n10.1007/BF01656260\n10.1161/01.CIR.95.5.1320\n10.1161/CIRCIMAGING.111.965335\n10.3389/fphys.2018.00520\n10.1080/14779072.2017.1308252\n10.1016/j.healun.2008.08.012\n10.1002/ehf2.12685",
    "journal": "Journal of cardiothoracic surgery",
    "keywords": [
        "Dilated cardiomyopathy",
        "Early post-implant right ventricular failure",
        "Heart transplantation",
        "Left ventricular assisted device"
    ],
    "methods": null,
    "publication_date": "2023-10-05",
    "pubmed_id": "37794433\n32386998\n22910091\n21530314\n18510965\n20132950\n19327526\n18721570\n26564619\n16143231\n24088902\n3885585\n9054866\n21940507\n29867563\n28306362\n19059106\n32426932",
    "results": null,
    "title": "Successful echocardiography-guided medical management of severe early post-implant right ventricular failure in a patient with left ventricular assist device support: a case report.",
    "xml": "<Element 'PubmedArticle' at 0x788505d34180>"
}