Novel Applications of a Percutaneous Dual-Lumen Cannula Beyond a Right Ventricular Assist Device

The ProtekDuo's dual-lumen design combined with its ability to be inserted percutaneously allows for its use in a wide variety of clinical scenarios. Therefore, it was chosen to be used as the venous cannula on cardiopulmonary bypass to treat a patient who had a high risk of right ventricular failure and a need for mechanical circulatory support postoperatively. Biventricular failure occurred during the patient's course in hospital, and the ProtekDuo was used in a novel hybrid configuration using both the distal port on the ProtekDuo and the aortic cannula as outflow cannula for the extracorporeal membrane oxygenation circuit, and the proximal port on the ProtekDuo was used as the venous return. Gradually increasing ProtekDuo distal outflow and decreasing aortic cannula outflow facilitated an isolated and progressive loading of the left ventricle while maintaining support for the right ventricle. In total, four separate mechanical circulatory support configurations were used to support and optimize the patient's hemodynamics. The ability to utilize a single cannula in a hybrid manner may be useful in patients requiring controlled weaning of mechanical circulatory support.