Oxy Right Ventricular Assist Device Using Extracoporeal Membrane Oxygenation as a Bridge to Lung Transplant for Right Ventricular Failure

Lee, S.; Kim, D.

doi:10.1016/j.healun.2020.01.495

Cited by 3 publications

(2 citation statements)

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“…Even though the use of the ProtekDuo cannula for right heart failure is becoming increasingly widely accepted (4,5), the use of the ProtekDuo as a bridge to lung transplantation is rarely reported in the literature (6,7). The use of the ProtekDuo cannula either in the intra-operative or posttransplant setting has been recently reported (8,9), as well as centrally cannulated oxyRVAD bridging to lung transplant (10,11). Therefore, oxyRVAD bridging to lung transplantation with the ProtekDuo cannula could be a potential bridging method for critically ill patients with end-stage lung disease preventing peripheral arterial cannulation or central cannulation.…”

Section: Discussionmentioning

confidence: 99%

Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

Harano¹,

Chan²,

Furukawa³

et al. 2022

J Thorac Dis

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Background: Oxygenated right ventricular assist device (oxyRVAD) placement has become more streamlined with the introduction of the dual-lumen pulmonary artery cannula. Peripherally cannulated oxyRVAD may provide oxygenation support with right heart support as an alternative to venoarterial extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation.Methods: A single-institution, retrospective analysis was performed on patients placed on oxyRVAD with a dual-lumen pulmonary artery cannula with the intention of bridging to lung transplantation in 2019.Results: Four patients with idiopathic pulmonary fibrosis were placed on oxyRVAD as a bridge to transplantation. Two patients were extubated and ambulated while waiting for a lung offer, and two patients required conversion to venoarteriovenous ECMO (VAV ECMO) from oxyRVAD. The median waiting time for extracorporeal life support (ECLS) was 42 h. All patients underwent double lung transplantation.Two patients stayed on oxyRVAD, and one patient was placed on venovenous ECMO (VV ECMO) after transplantation. Primary graft dysfunction score at 72 h after transplantation was grade 1 in three patients and grade 3 in one patient.Conclusions: Peripherally cannulated oxyRVAD with percutaneous dual-lumen venous cannula could be an ambulatory bridge for lung transplantation. It is unknown whether oxyRVAD is feasible as a long-term bridge to lung transplantation.

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Section: Discussionmentioning

confidence: 99%

Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

Harano¹,

Chan²,

Furukawa³

et al. 2022

J Thorac Dis

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“…One of the advantages of this RVAD platform is that it can be oxygenated. 15,26,27 Providing consistent oxygenation and removal of CO 2 with avoidance of respiratory acidosis ensures optimal conditions for the pulmonary arterial system. The pulmonary vasculature is exquisitely sensitive to hypoxemia and acidosis and therefore, an oxygenated RVAD as an ECMO circuit diminishes the inducible pulmonary vasoconstriction and greatly reduces RV afterload.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Monitoring in Patients With Dual Lumen Right Atrium to Pulmonary Artery Right Ventricular Assist Device

et al. 2022

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Right ventricular assist devices (RVADs) can be used in patients with acute right heart failure. A novel device that has recently been deployed is the right atrium to pulmonary artery (RA-PA) dual lumen single cannula (DLSC). One of the limitations is that it occupies a large proportion of the right ventricular outflow tract and PA; therefore, standard continuous hemodynamic monitoring with a pulmonary artery catheter is commonly not used. Serial echocardiography is pivotal for device deployment, monitoring device position, assessing RV readiness for decannulation, and surveilling for short-term complications. We performed a retrospective case series of 24 patients with RA-PA DLSC RVAD assessing echocardiographic RV progression and vasoactive infusion requirements. The overall survival was 66.6%. The average vasoactive infusion score at the time of cannulation was 24.9 ± 43.9, at decannulation in survivors 4.6 ± 4.9 vs. 25.4 ± 21.5 in nonsurvivors, and 2.7 ± 4.9 at 48 hours post decannulation. On echocardiography, the average visual estimate of RV systolic function encoded (0 = none and 5 = severe) in survivors was 3.9 ± 1.2, 2.8 ± 1.6, 2.5 ± 1.7, and 2.8 ± 1.9, respectively, and in nonsurvivors 3.8 ± 1.6 and 3.4 ± 1.8, respectively. This demonstrated an RV systolic function improvement over time in survivors as opposed to nonsurvivors. This was also demonstrated in RV size visual estimate, respectively. Quantitatively, at the predefined four timepoints, the RV:LV, tricuspid annular plane systolic excursion, and fractional area change all improve over time and there is statistically significant difference in survivors versus nonsurvivors. In this study, we describe a cohort of patients treated with RA-PA DLSC RVAD. We illustrate the critical nature of echocardiographic measures to rate the progression of RV function, improvement in vasoactive infusion requirements, and ventilator parameters with the RA-PA DLSC.

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Venopulmonary extracorporeal membrane oxygenation for right ventricular support as a bridge to lung transplantation: A narrative review

Thuan,

Nam,

Dinh

2024

SAGE Open Medicine

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This review evaluates the effectiveness of veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation strategy in patients undergoing veno-venous extracorporeal membrane oxygenation while awaiting lung transplantation. Examining indications, contraindications, and clinical outcomes, the study highlights potential benefits, drawing insights from successful cases in South Korea and the United States. Despite limited sample sizes, veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation emerges as a promising approach for further investigation in lung transplantation support. The review emphasizes its role in improving hemodynamic status, preventing complications during extended waiting periods, and presenting a cost-effective alternative to traditional methods, especially in developing countries. While in-hospital mortality rates range from 0% to 10%, comparable to other approaches, cautious optimism surrounds veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation, urging expanded research to solidify its standing in enhancing patient outcomes, reducing costs, and promoting transplant success.

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Oxy Right Ventricular Assist Device Using Extracoporeal Membrane Oxygenation as a Bridge to Lung Transplant for Right Ventricular Failure

Cited by 3 publications

References 0 publications

Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

Comprehensive Monitoring in Patients With Dual Lumen Right Atrium to Pulmonary Artery Right Ventricular Assist Device

Venopulmonary extracorporeal membrane oxygenation for right ventricular support as a bridge to lung transplantation: A narrative review

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