Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

Vijayakumar, Niranjan; Badheka, Aditya; Chegondi, Madhuradhar; McLennan, Daniel

doi:10.1177/0267659120923880

Cited by 16 publications

(21 citation statements)

References 8 publications

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“…An alternative to VA‐ECMO has emerged for patients with right ventricular failure with the advent of ProtekDuo (CardiacAssist, Inc, Pittsburgh, PA) providing both respiratory support and right ventricular support 2 . Advantages of ProtekDuo cannula include percutaneous placement, allowing a prolonged use, early extubation and mobilization (preventing deconditioning, myopathy, and thromboembolism), and improving effectiveness and consistency of gas exchange by eliminating recirculation.…”

Section: Discussionmentioning

confidence: 99%

“…However, even when Avalon cannula has been appropriately placed using adequate guidance, 10 there is still a substantial risk of recirculation, which can increase, and more worryingly fluctuate, when the patient ambulates—with ensuing complications as described above. Vijayakumar et al describe the successful use of ProtekDuo as a rescue mechanism in a patient with congenital heart disease who developed severe hypoxemia due to recirculation after the placement of Avalon dual‐lumen cannula 2 . Takeda et al propose a minimal invasive approach for ventricular assist device (VAD) for cardiogenic shock with or without ECMO as a bridge for decision therapy.…”

Section: Discussionmentioning

confidence: 99%

“…However, both veno‐venous ECMO (VV‐ECMO) and veno‐arterial ECMO (VA‐ECMO) have several disadvantages and ProtekDuo has emerged as an alternative. ProtekDuo is a dual‐lumen single cannula inserted in the right internal jugular vein that bypasses the right ventricle (RV), thus decompressing it providing both respiratory support and right ventricular support while eliminating recirculation 2 . This article describes two cases of the successful use of ProtekDuo as bridge to heart‐lung transplantation and lung transplantation, respectively, at Houston Methodist Hospital (HMH).…”

Section: Introductionmentioning

confidence: 99%

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ProtekDuo as a bridge to lung transplant and heart‐lung transplant

Sinha

Goodarzi

Akku

et al. 2021

Clinical Transplantation

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Recent advances in technology have led to significantly greater use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation with better outcomes. The novel ProtekDuo veno‐venous ECMO (CardiacAssist, Inc.) has gained significance as it facilitates effective decompression of the right heart in patients with acute decompensation, while also providing consistent and effective gas exchange by eliminating recirculation. Here, we report two cases of effectively using ProtekDuo veno‐venous ECMO: one case as a bridge to lung transplantation and another case as a bridge to heart‐lung transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ProtekDuo as a bridge to lung transplant and heart‐lung transplant

Sinha

Goodarzi

Akku

et al. 2021

Clinical Transplantation

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“…With an oxygenator this configuration is called an oxy-RVAD. 6,7 One of the challenges associated with these cannulation strategies is that blood that returns from the thebesian veins as well as blood that circumvents the RA into the RV may not be adequately drained by the single right atrial drainage port. In December 2021, the Food and Drug Administration approved a new dual-stage dual lumen single cannula RVAD manufactured by Spectrum (Figures 1 and 2).…”

mentioning

confidence: 99%

First‐in‐man successful use of the SPECTRUM percutaneous dual‐stage right ventricle and right atrium to pulmonary artery ventricular assist device

Usman¹,

Spelde²,

Olia³

et al. 2022

Journal of Cardiac Surgery

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Background: Over the past decade, several minimally invasive mechanical support devices have been introduced into clinical practice to support the right ventricle (RV). Percutaneous cannulas are easy to insert, minimally invasive, and treat acute RV failure rapidly. In December 2021, the Food and Drug Administration approved a new 31 French dual lumen single cannula for use as a right ventricular assist device. Aims: Descirbe the use of the new dual lumen percutaneous right ventricular assist device (RVAD) cannula. Material and Methods: Deployment of the RVAD can be done surgically or percutaneously. This cannula, manufactured by Spectrum, is dual staged. It has inflow ports positioned both in the right atrium (RA) as well as the RV for maximal drainage of the right heart. The distal end of the cannula which includes the outflow port is positioned in the pulmonary artery (PA). Results: Deployment of the Spectrum RVAD can be done percutaneously with transesophageal and flouroscopy guidence. Cannulation requires requisite wire skills in order to navigate into the main pulmonary artery. Utilization of this cannula can be done in acute RV failure secondary to ischemia, post cardiotomy shock, acute respiratory failure or other causes of isolated RV failure. Discussion: The dual stage drainage design optimizes venous drainage as well as limits suck-down events. Theoretically, direct RV decompression also decreases RV dilation and wall tension, and facilitates improved transmural pressure gradient to reduce RV strain. Conclusion: Here we describe the first-in-man successful use of the dual-stage RA and RV to PA Spectrum cannula in a patient with severe COVID acute respiratory distress syndrome and acute right ventricular failure, bridged to recovery.

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“…4 The TandemHeart Protek Duo (TPD, TandemLife, Pittsburgh, PA), on the other hand, is an extracorporeal right ventricular assist device that involves placement of a cannula through the right internal jugular vein with its tip in the main pulmonary artery (PA). 5 The drainage occurs from the right atrial orifice, and ejection occurs in the PA. Malposition of the device can cause several life-threatening complications, such as arrhythmias and acute right ventricular (RV) overload. 2 The authors present 2 cases, one in which the tip of an IABP inserted through the axillary artery migrated into the left ventricle and the other in which the tip of the TPD migrated back into the right ventricle.…”

mentioning

confidence: 99%