Affiliation

• ¹Department of Renal Medicine, St Vincents Hospital, Sydney, New South Wales, Australia
• ²Department of Cardiology, St Vincents Hospital, Sydney, New South Wales, Australia
• ³Department of Heart Failure and Transplantation, St Vincents Hospital, Sydney, New South Wales, Australia
• ⁴Head of Department of Renal Medicine/ Director of Medicine, St Vincents Hospital, Sydney, New South Wales, Australia

Corresponding Author

Chris Anthony. MBBS Department of Cardiology, Renal Medicine, Heart Failure and Transplantation, St Vincents Hospital, Sydney, 1/569 George Street, Sydney-2000, New South Wales, Australia, Tel: 0061424132549; E-mail: chris007_7@hotmail.com / canthony@stvincents.com.au

Citation

Anthony, C., et al. Tenckhoff Catheter Implantation in Refractory Ascites Due to Right Heart Failure. (2016) J Heart Cardiol 2(1): 12-16.

Copy rights

© 2016 Anthony, C . This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.

Keywords

Abstract

  Tenckhoff catheter implantation and modified peritoneal dialysis as a novel therapeutic approach in diuretic resistant congestive heart failure: a single-centre case-series.
Background: Progressive renal insufficiency and diuretic resistance represent significant challenges in the management of advanced heart failure, particularly in the context of intractable ascites due to Right Heart Failure (RHF). There is growing interest in the potential use of intermittent paracentesis and peritoneal dialytic ultra-filtration in this setting but clinical experience is limited.
Methods: We undertook retrospective analysis of changes in the following clinical parameters in six patients (66% males, average age 53 years) who underwent Tenckhoff catheter implantation (TCI) for the management of RHF-related intractable ascites i) body weight; ii) number of heart failure related admissions and time spent in hospital; and iii) diuretic requirements. Student t-test was performed to analyse statistical significance.
Results: Follow-up ranged from 4 to 16 weeks post TCI. Compared to immediately prior to TCI: i) 83% (5/6) of patients experienced an improvement in renal function; ii) average weight fell from 72.2 + 4.7 to 67.7 + 3.9 kg (mean + SEM, p = 0.054); iii) none of the patients have required heart failure related admission compared to an average number of 40 days in hospital over 6.7 admissions in the twelve months preceding TCI and iv) frusemide dose decreased from 263 + 49 to 140 + 50 mg/day, p = 0.051). All patients report a subjective improvement in overall wellbeing and quality of life. One patient developed peritonitis which was controlled with antibiotic treatment without needing catheter removal.
Conclusion: Our experience supports the use of TCI as a therapeutic modality in patients with RHF and intractable ascites resistant to medical management.