Version 1
: Received: 5 December 2023 / Approved: 7 December 2023 / Online: 7 December 2023 (16:41:21 CET)
How to cite:
Assouline, B.; Mugnai, D.; Hagerman, A.; Wuarin, L.; Schopfer, L.; Bendjelid, K.; Giraud, R. Switching from VA-ECMO to a Percutaneous Right Ventricular Assist Device as a Bridge to Recovery in a Case of Right Ventricular Myocardial Infarction. Preprints2023, 2023120501. https://doi.org/10.20944/preprints202312.0501.v1
Assouline, B.; Mugnai, D.; Hagerman, A.; Wuarin, L.; Schopfer, L.; Bendjelid, K.; Giraud, R. Switching from VA-ECMO to a Percutaneous Right Ventricular Assist Device as a Bridge to Recovery in a Case of Right Ventricular Myocardial Infarction. Preprints 2023, 2023120501. https://doi.org/10.20944/preprints202312.0501.v1
Assouline, B.; Mugnai, D.; Hagerman, A.; Wuarin, L.; Schopfer, L.; Bendjelid, K.; Giraud, R. Switching from VA-ECMO to a Percutaneous Right Ventricular Assist Device as a Bridge to Recovery in a Case of Right Ventricular Myocardial Infarction. Preprints2023, 2023120501. https://doi.org/10.20944/preprints202312.0501.v1
APA Style
Assouline, B., Mugnai, D., Hagerman, A., Wuarin, L., Schopfer, L., Bendjelid, K., & Giraud, R. (2023). Switching from VA-ECMO to a Percutaneous Right Ventricular Assist Device as a Bridge to Recovery in a Case of Right Ventricular Myocardial Infarction. Preprints. https://doi.org/10.20944/preprints202312.0501.v1
Chicago/Turabian Style
Assouline, B., Karim Bendjelid and Raphaël Giraud. 2023 "Switching from VA-ECMO to a Percutaneous Right Ventricular Assist Device as a Bridge to Recovery in a Case of Right Ventricular Myocardial Infarction" Preprints. https://doi.org/10.20944/preprints202312.0501.v1
Abstract
Background
Acute right heart failure (RHF) is associated with high morbidity and mortality. Temporary mechanical circulatory support (tMCS) is now part of the advanced management strategy for refractory cardiogenic shock (CS). Among such support systems, VA-ECMO remains the fastest MCS system to set up. The ProtekDuo cannula can be used as a temporary and percutaneous right ventricular assist device (RVAD) in relay with VA-ECMO in the context of prolonged weaning.
Case Summary
This case report describes the clinical course of a 69-year-old patient who underwent elective aortic valve replacement surgery complicated by acute RHF due to iatrogenic ligation of the right coronary artery. VA-ECMO was initiated in the context of refractory cardiogenic shock. Faced with prolonged MCS weaning, due to lack of recovery of the right ventricle associated with the absence of any other therapeutic option, a percutaneous RVAD via a ProtekDuo cannula was implanted as a bridge to recovery. The ProtekDuo was gradually weaned while the patient began rehabilitation. The patient was transferred to the medical ward after 5 weeks in the ICU, stayed 5 months in an acute medical setting, went to a rehabilitation center afterward and returned home 6 months after the initial surgery without any neurological sequalae or organ failures. In total, she remained on MCS for 39 days (21 on VA-ECMO and 18 on ProtekDuo).
Discussion
In cases of refractory RHF, after stabilization and organ perfusion restoration under VA-ECMO, it is feasible to switch to a percutaneous RVAD, allowing early mobilization of patients during prolonged MCS weaning until the right ventricle adapts to new loading conditions.
Keywords
VA-ECMO; Short-term mechanical assist device; Right ventricular assist device; ProtekDuo; Cardiogenic shock; Right ventricular myocardial infarction.
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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