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Percutaneous haemodynamic and renal support in patients presenting with decompensated heart failure: A multi-centre efficacy study using the Reitan Catheter Pump (RCP)

Journal article
Authors T. R. Keeble
G. V. Karamasis
M. T. Rothman
Sven-Erik Ricksten
M. Ferrari
R. Hullin
F. Schersten
O. Reitan
S. T. Kirking
J. G. F. Cleland
E. J. Smith
Published in International Journal of Cardiology
Volume 275
Pages 53-58
ISSN 0167-5273
Publication year 2019
Published at Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
Pages 53-58
Language en
Links dx.doi.org/10.1016/j.ijcard.2018.09...
Keywords Decompensated heart failure, Congestion, Cardiac support, Renal dysfunction, ventricular assist devices, circulatory support, relax-ahf, dysfunction, serelaxin, outcomes
Subject categories Cardiac and Cardiovascular Systems

Abstract

Background: Worsening heart failure complicated by congestion, hypotension, and renal dysfunction is difficult to manage, increasingly common and predicts a poor outcome. Novel therapies are required to facilitate diuresis and implementation of disease-modifying interventions in preparation for hospital discharge. Accordingly, we investigated the haemodynamic and renal effects of the Reitan Catheter Pump (RCP) percutaneous support device in patients admitted with decompensated heart failure (DHF). Methods: This was a prospective observational study of 20 patients admitted with DHF, ejection fraction < 30%, and Cardiac index (CI) < 2.1 L/min/m(2) in need of inotropic/mechanical support. Results: Patients underwent RCP support for a mean of 18.3 (+/- 6.3) hours. The RCP increased CI from 1.84 L/min/m(2) (+/- 0.27), to 2.41 L/min/m(2) (+/- 0.45, p = 0.04), increased urine output (71 mL/h (+/- 65) to 227 ml/h (+/- 179) (p = 0.006) with a concomitant reduction in serum creatinine (188 mu mol/L (+/- 87) to 161 mu mol/L (+/- 78) (p = 0.0007). There were no clinically significant haemolysis, vascular injury, or thromboembolic complications. Conclusions: For patients admitted with DHF, the RCP improves cardiac index, diuresis and renal function without causing important complications. (c) 2018 Published by Elsevier B.V.

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