Percutaneous oxygenated right ventricular assist device for pulmonary embolism: a case series
File(s)
Author(s)
Lee, Teresa ML
Bianchi, Paolo
Kourliouros, Antonios
Price, Laura C
Ledot, Stephane
Type
Journal Article
Abstract
Acute right ventricular (RV) failure following massive pulmonary embolism (PE) can have significant hemodynamic consequences and is the mode of death. Temporary mechanical circulatory support can provide tissue perfusion required while thrombectomy or lysis-aimed therapies act to relieve the thrombotic obstruction. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has conventionally been the first line MCS. A more selective approach to RV support has been advocated in the form of an extracorporeal right ventricular assist device (RVAD) as it mitigates some of the shortcomings of V-A ECMO. We present the first case series of four patients who received fully percutaneous RVAD, with an integrated oxygenator forming an Oxy-RVAD, for selective right heart support following massive PE, including the application of single-access dual-lumen right atrium to pulmonary artery cannula. All patients achieved RV recovery and were successfully weaned from oxy-RVAD support within 5–10 days demonstrating the feasibility of selective percutaneous right heart support in managing these challenging patients.
Date Issued
2023-03-01
Date Acceptance
2022-09-22
Citation
Artificial Organs, 2023, 47 (3), pp.595-603
ISSN
0160-564X
Publisher
Wiley
Start Page
595
End Page
603
Journal / Book Title
Artificial Organs
Volume
47
Issue
3
Copyright Statement
© 2022 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. This is the peer reviewed version of the following article:Lee TML, Bianchi P, Kourliouros A, Price LC, Ledot S. Percutaneous oxygenated right ventricular assist device for pulmonary embolism: A case series. Artif Organs. 2023; 47: 595–603. which has been published in final form at https://doi.org/10.1111/aor.14420. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/36265137
Subjects
dual-lumen cannula
Engineering
Engineering, Biomedical
EXTRACORPOREAL MEMBRANE-OXYGENATION
Life Sciences & Biomedicine
MECHANICAL CIRCULATORY SUPPORT
OUTCOMES
percutaneous
pulmonary embolism
right ventricular assist device
Science & Technology
Technology
Transplantation
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2022-10-20