[A case report of biventricular assistance by means of ventricular assist device and IABP in postoperative biventricular failure].

Three patients with biventricular failure were managed postoperatively with the aid of a right ventricular assist device (RVAD) and intraaortic balloon pumping (IABP) with favorable results. Among these three cases, two had multiple rheumatic valvular disease with cardiac cachexia and underwent combined valve replacement. Another who was suffered from heart failure with a large ventricular septal defect and tricuspid regurgitation had a VSD closure and tricuspid valve replacement. In all patients, the weaning from pump oxygenator was difficult even with large doses of catecholamine. Therefore, the pump oxygenator was switched to RVAD for right ventricular assistance and IABP for left ventricular assistance because these patients had had right ventricular failure dominant biventricular failure preoperatively. Though case 2 was lost 64 days after the surgery by retroperitoneal bleeding due to inadequate anticoagulant treatment, the other two cases recovered successfully from postoperative biventricular failure and were discharged from the hospital. The indications of this method and the criteria for RVAD weaning were discussed.