Right Ventricular Mechanical Support With ProtekDuo Cannula as a Bridge to Recovery After Post-Infarction Ventricular...

Area of Science:

• Cardiology
• Mechanical Circulatory Support
• Cardiac Surgery

Background:

• Post-myocardial infarction ventricular septal defect (VSD) is a severe complication.
• Right ventricular failure and cardiogenic shock often accompany VSD.
• Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may be insufficient for isolated right ventricular dysfunction.

Purpose of the Study:

• To report the successful use of prolonged isolated right ventricular mechanical support.
• To evaluate the ProtekDuo cannula system in a complex post-infarction VSD case.
• To demonstrate a bridge to recovery strategy for refractory cardiogenic shock.

Main Methods:

• A patient with inferior myocardial infarction complicated by VSD and refractory cardiogenic shock was treated.
• Initial surgical repair was unsuccessful, and weaning from VA-ECMO was not possible.
• The patient was transitioned to ProtekDuo-based isolated right ventricular assist support.

Main Results:

• Hemodynamic stabilization was achieved with ProtekDuo support.
• Veno-arterial ECMO was successfully withdrawn.
• Right ventricular assist support was maintained for 51 days without complications, leading to myocardial recovery and subsequent percutaneous VSD closure.
• Total mechanical circulatory support duration was 77 days.

Conclusions:

• Prolonged isolated right ventricular support with ProtekDuo is feasible and durable.
• This approach can serve as a bridge to recovery in complex post-infarction VSD.
• The ProtekDuo system offers a viable option for managing refractory right ventricular failure.