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Schurman AM, Cain MT, Joyce DL, Durham LA, Ishizawar D, Mohammed A, Joyce LD. Minimally Invasive Mechanical Circulatory Support Through the Perioperative Pulmonary Thromboendarterectomy Period: A Case Report. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2020; 15:173-176. [DOI: 10.1177/1556984520904790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 64-year-old man being evaluated for pulmonary thromboendarterectomy (PTE) preoperatively experienced pulseless electrical activity secondary to right ventricular failure while undergoing bronchoscopy. After return of spontaneous circulation, a percutaneous right ventricular assist device (RVAD) was placed through the right internal jugular vein. He continued on right ventricular support with demonstration of right ventricular recovery over the following 8 days, and subsequently underwent PTE for treatment of his primary condition. He recovered and was weaned from his RVAD support uneventfully. The need for RVAD support has traditionally been a contraindication for PTE; however, circulatory assist devices have been used as a salvage procedure for right-heart failure after PTE. This case highlights the potential for percutaneous mechanical circulatory support in treating severe perioperative right ventricular dysfunction, and to facilitate successful recovery in patients undergoing PTE.
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Affiliation(s)
| | | | - David L. Joyce
- Division of Cardiothoracic, Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA
| | - Lucian A. Durham
- Division of Cardiothoracic, Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA
| | - David Ishizawar
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Wauwatosa, USA
| | - Asim Mohammed
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Wauwatosa, USA
| | - Lyle D. Joyce
- Division of Cardiothoracic, Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA
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