Current Landscape of Temporary Percutaneous Mechanical Circulatory Support Technology

Upadhyay, Rani; Alrayes, Hussayn; Arno, Scott; Kaushik, Milan; Basir, Mir B.

doi:10.15420/usc.2021.15

Cited by 6 publications

(4 citation statements)

References 49 publications

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“…This also reduces ventricular interdependence and leftward shift of the interventricular septum that may occur in RVF. The ProtekDuo cannula, when connected to a pump, can deliver approximately 4.5–5 L of flow per minute, depending on the cannula’s size ( 5 ). The ProtekDuo cannula and TandemHeart pump are approved for use for up to 6 days by the US Food and Drug Administration (FDA) and up to 30 days by the European Medicines Evaluation Agency (EMEA) ( 6 ).…”

Section: Protekduo—design and Impact On Rv Physiologymentioning

confidence: 99%

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

John,

Nabzdyk,

Chweich

et al. 2024

Ann Transl Med

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The ProtekDuo (LivaNova, London, UK) cannula is a dual-lumen device, typically inserted into the right internal jugular (IJ) vein through a percutaneous approach, with fluoroscopy or ultrasound guidance. When connected to a pump, such as the TandemHeart (LivaNova, London, UK) or CentriMag (Abbott, Pleasanton, CA, USA), it can function as a right ventricular (RV) mechanical circulatory support (MCS). When an oxygenator is also added [veno-pulmonary (V-P)], it can provide extracorporeal membrane oxygenation (ECMO) support. This review aims to provide a comprehensive overview of the device’s physiology and clinical applications. In the setting of RV failure (RVF), the ProtekDuo cannula, with its outflow in the main pulmonary artery (PA), can bypass the failing RV, improving pulmonary flow, left atrial (LA) filling pressures, and left ventricular (LV) preload. This can also reduce ventricular interdependence and leftward shift of the interventricular septum that occurs in RVF. In this review, the key sections expand on the use of the ProtekDuo cannula in the management of critically ill patients, specifically, the use of ProtekDuo for RV myocardial infarction (MI) RVF, LV assist device (LVAD) implantation-associated RVF, RVF post-heart transplantation, temporary biventricular MCS as bridge to recovery (ECpella 2.0 or PROpella), biventricular support as bridge to recovery or decision, isolated LV failure, post lung transplantation (LT) care, and other miscellaneous clinical scenarios. ProtekDuo is an important tool in the armory of RVF management. The ProtekDuo system is expected to gain more popularity given its clear advantages such as groin-free approach allowing for mobility, easy percutaneous deployment, compatibility with various pumps and oxygenators, and the versatility to be integrated in numerous configurations. In an era of expanding MCS options, further research is needed to better understand the optimal tool for specific patient subsets.

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Section: Protekduo—design and Impact On Rv Physiologymentioning

confidence: 99%

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

John,

Nabzdyk,

Chweich

et al. 2024

Ann Transl Med

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“…Other mechanical circulatory support devices require larger sheath diameters: for example, Impella requires sheaths ranging from 13F for the 2.5L version up to 23F for the 5.5L version, and the iVAC 2L requires 18F and TandemHeart 15F up to 19F sheaths. 88 In these cases, ultrasound-guided access is advised and hemostasis should primarily be done by dedicated VCDs or by surgical closure. VCDs that are most commonly used include the suture-based ProGlide/Style and Prostar (Abbott Vascular) and the plug-based Manta (Teleflex).…”

Section: Mechanical Supportmentioning

confidence: 99%

Vascular Access in Percutaneous Coronary Intervention of Chronic Total Occlusions: A State-of-the-Art Review

Meijers

Aminian

Valgimigli

et al. 2023

Circ: Cardiovascular Interventions

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The outcomes of chronic total occlusion percutaneous coronary intervention have considerably improved during the last decade with continued emphasis on improving procedural safety. Vascular access site bleeding remains one of the most frequent complications. Several procedural strategies have been implemented to reduce the rate of vascular access site complications. This state-of-the-art review summarizes and describes the current evidence on optimal vascular access strategies for chronic total occlusion percutaneous coronary intervention.

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“…The system supports up to 5 l/min of blood flow, and an oxygenator can be inserted for extracorporeal membrane oxygenation (ECMO). The ProtekDuo is manufactured in two sizes (29F and 31F) and is typically inserted via the right internal jugular vein 14 .…”

Section: Percutaneous Right Ventricular Devicesmentioning

confidence: 99%

Temporary mechanical circulatory support devices: practical considerations for all stakeholders

et al. 2022

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Originally intended for life-saving salvage therapy, the use of temporary mechanical circulatory support (MCS) devices has become increasingly widespread in a variety of clinical settings in the contemporary era. Their use as a short-term, prophylactic support vehicle has expanded to include procedures in the catheterization laboratory, electrophysiology suite, operating room and intensive care unit. Accordingly, MCS device design and technology continue to develop at a rapid pace. In this Review, we describe the functionality, indications, management and complications associated with temporary MCS, together with scenario-specific utilization, goal-directed development and bioengineering of future devices. We address various considerations for the use of temporary MCS devices in both prophylactic and rescue scenarios, with input from stakeholders from v ar io us c ar di ovascular specialties, including interventional and heart failure cardiology, electrophysiology, cardiothoracic anaesthesiology, critical care and cardiac surgery.

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Current Landscape of Temporary Percutaneous Mechanical Circulatory Support Technology

Cited by 6 publications

References 49 publications

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

ProtekDuo percutaneous ventricular support system—physiology and clinical applications

Vascular Access in Percutaneous Coronary Intervention of Chronic Total Occlusions: A State-of-the-Art Review

Temporary mechanical circulatory support devices: practical considerations for all stakeholders

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