Minimally Invasive Temporary Right Ventricular Assist Device for Acute Right Ventricular Failure

Abstract

Minimally invasive approaches to acute mechanical circulatory support are needed to reduce hemorrhagic and other complications. We describe our minimally invasive approach to right ventricular assist device placement in patients with acute, non-postcardiotomy, right ventricular failure.

Minimally invasive insertion of off-pump central extracorporeal membrane oxygenation

“…1 We illustrate a minimally invasive off pump technique for initiation of central extracorporeal membrane oxygenation (ECMO) using trans-apical insertion of an extracorporeal dual-lumen cannula (PROTEK Duo, TandemLife, Pittsburgh, PA). 1 We illustrate a minimally invasive off pump technique for initiation of central extracorporeal membrane oxygenation (ECMO) using trans-apical insertion of an extracorporeal dual-lumen cannula (PROTEK Duo, TandemLife, Pittsburgh, PA).…”

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In an attempt to minimize the morbidity associated with establishing mechanical support for the acutely failing right or left ventricle, minimally invasive techniques have been developed for the initiation of temporary mechanical support. 1 We illustrate a minimally invasive off pump technique for initiation of central extracorporeal membrane oxygenation (ECMO) using trans-apical insertion of an extracorporeal dual-lumen cannula (PROTEK Duo, TandemLife, Pittsburgh, PA). 2 Technique Initiation of central ECMO was established via a left mini-thoracotomy approach that allows for complete visualization and access to the anterior wall and apex of the left ventricle (LV).

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“…In an attempt to minimize the morbidity associated with establishing mechanical support for the acutely failing right or left ventricle, minimally invasive techniques have been developed for the initiation of temporary mechanical support. 1 intake ports of the cannula located approximately 1 cm from the LV endocardium, and the outlet ports and cannula tips extending 2-3 cm above the aortic valve (Figure 4). Blood is then cycled through the cannula with flows achieving 4.5 L/min via an extracorporeal membrane oxygenator and pump (Maquet Cardiohelp ECMO circuit, Getinge Group, Rastatt, AG).…”