The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Benefits of a novel percutaneous ventricular assist device for right heart failure: The prospective RECOVER RIGHT study of the Impella RP device

Published:September 08, 2015DOI:


      Right ventricular failure (RVF) increases morbidity and mortality. The RECOVER RIGHT study evaluated the safety and efficacy of a novel percutaneous right ventricular assist device, the Impella RP (Abiomed, Danvers, MA), in a prospective, multicenter trial.


      Thirty patients with RVF refractory to medical treatment received the Impella RP device at 15 United States institutions. The study population included 2 cohorts: 18 patients with RVF after left ventricular assist device (LVAD) implantation (Cohort A) and 12 patients with RVF after cardiotomy or myocardial infarction (Cohort B). The primary end point was survival to 30 days or hospital discharge (whichever was longer). Major secondary end points included indices of safety and efficacy.


      The patients (77% male) were a mean age of 59 ± 15 years, 53% had diabetes, 88.5% had a history of congestive heart failure, and 37.5% had renal dysfunction. Patients were on an average of 3.2 inotropes/pressors. Device delivery was achieved in all but 1 patient. Hemodynamics improved immediately after initiation of Impella RP support, with an increase in cardiac index from 1.8 ± 0.2 to 3.3 ± 0.23 liters/min/m2 (p < 0.001) and a decrease in central venous pressure from 19.2 ± 4 to 12.6 ± 1 mm Hg (p < 0.001). Patients were supported for an average of 3.0 ± 1.5 days (range, 0.5–7.8 days). The overall survival at 30 days was 73.3%. All patients discharged were alive at 180 days.


      In patients with life-threatening RVF, the novel percutaneous Impella RP device was safe, easy to deploy, and reliably resulted in immediate hemodynamic benefit. These data support its probable benefit in this gravely ill patient population.


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        • Goldstein J.A.
        • Kern M.J.
        Percutaneous mechanical support for the failing right heart.
        Cardiol Clin. 2012; 30: 303-310
        • Kormos R.L.
        • Teuteberg J.J.
        • Pagani F.D.
        • et al.
        HeartMate II Clinical Investigators. Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: Incidence, risk factors and effect on outcomes.
        J Thorac Cardiovasc Surg. 2010; 139: 316-324
        • Douglas P.S.
        • DeCara J.M.
        • Devereux R.B.
        • et al.
        Echocardiographic imaging in clinical trials: American Society of Echocardiography standards for echocardiography core laboratories: endorsed by the American College of Cardiology Foundation.
        J Am Soc Echocardiogr. 2009; 22: 755-766
        • Haneya A.
        • Philipp A.
        • Puehler T.
        • et al.
        Temporary percutaneous right ventricular support using a centrifugal pump in patients with postoperative acute refractory right ventricular failure after left ventricular assist device implantation.
        Eur J Cardiothorac Surg. 2012; 41: 219-223
        • Kapur N.K.
        • Paruchuri V.
        • Korabathina R.
        • et al.
        Effects of a percutaneous mechanical circulatory support device for medically refractory right ventricular failure.
        J Heart Lung Transplant. 2011; 30: 1360-1367
        • Potapov E.
        • Meyer D.
        • Swaminathan M.
        • et al.
        Inhaled nitric oxide after left ventricular assist device implantation: a prospective, randomized, double-blind, multicenter, placebo-controlled trial.
        J Heart Lung Transplant. 2011; 30: 870-878
        • Aissaoui N.
        • Morshuis M.
        • Schoenbrodt M.
        • et al.
        Temporary right ventricular mechanical circulatory support for the management of right ventricular failure in critically ill patients.
        J Thorac Cardiovasc Surg. 2013; 146: 186-191
        • John R.
        • Long J.W.
        • Massey H.T.
        • et al.
        Outcomes of a multicenter trial of the Levitronix CentriMag ventricular assist system for short-term circulatory support.
        J Thorac Cardiovasc Surg. 2011; 141: 932-939
        • Cleveland Jr, J.C.
        • Naftel D.C.
        • Reece T.B.
        • et al.
        Survival after biventricular assist device implantation: an analysis of the Interagency Registry for Mechanically Assisted Circulatory Support database.
        J Heart Lung Transplant. 2011; 30: 862-869
        • Noly P.E.
        • Kirsch M.
        • Quessard A.
        • et al.
        Temporary right ventricular support following left ventricle assist device implantation: a comparison of two techniques.
        Interact Cardiovasc Thorac Surg. 2014; 19: 49-55
        • Khani-Hanjani A.
        • Loor G.
        • Chamogeorgakis T.
        • et al.
        Case series using the ROTAFLOW system as a temporary right ventricular assist device after HeartMate II implantation.
        ASAIO J. 2013; 59: 456-460
        • Takayama H.
        • Naka Y.
        • Kodali S.K.
        • et al.
        A novel approach to percutaneous right-ventricular mechanical support.
        Eur J Cardiothorac Surg. 2012; 41: 423-426
        • Bhama J.K.
        • Kormos R.L.
        • Toyoda Y.
        • Teuteberg J.J.
        • McCurry K.R.
        • Siegenthaler M.P.
        Clinical experience using the Levitronix CentriMag system for temporary right ventricular mechanical circulatory support.
        J Heart Lung Transplant. 2009; 28: 971-976
        • Cheung A.W.
        • White C.W.
        • Davis M.K.
        • Freed D.H.
        Short-term mechanical circulatory support for recovery from acute right ventricular failure: clinical outcomes.
        J Heart Lung Transplant. 2014; 33: 794-799
      1. Summary of safety and probable benefit. CentriMag® Right Ventricular Assist System (RVAS) for humanitarian use in patients in right heart failure-. Available at: Accessed January 9, 2015.