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Brewer JM, Maybauer MO. The ProtekDuo Cannula: A Comprehensive Review of Efficacy and Clinical Applications in Right Ventricular Failure. J Clin Med 2024; 13:4077. [PMID: 39064117 PMCID: PMC11278424 DOI: 10.3390/jcm13144077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Right ventricular failure (RVF) is a clinical challenge associated with various underlying acute and chronic medical conditions, necessitating diverse management strategies including mechanical circulatory support (MCS). The ProtekDuo cannula represents an important advancement in medical devices for MCS in the setting of RVF. When combined with an extracorporeal blood pump, the dual-lumen design allows for direct bypass of the RV using simultaneous drainage and return of blood using percutaneous, single-site access. Studies have reported favorable outcomes with the ProtekDuo cannula and low device-related complications, but comparative studies with other MCS devices are limited. Still, the ProtekDuo cannula has numerous advantages; however, it is not without challenges, and opportunities for further research exist. The ProtekDuo cannula holds significant potential for future advancements in the field of MCS, offering promising solutions for RVF management.
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Affiliation(s)
- Joseph M. Brewer
- Specialty Critical Care and Acute Circulatory Support Service, Nazih Zuhdi Transplant Institute, INTEGRIS Health Baptist Medical Center, Oklahoma City, OK 73112, USA
| | - Marc O. Maybauer
- Division of Critical Care Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL 32610, USA
- Department of Anaesthesiology and Intensive Care Medicine, Philipps University, 35037 Marburg, Germany
- Critical Care Research Group, Prince Charles Hospital, University of Queensland, Brisbane, QLD 4072, Australia
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Alam A, Baran DA, Doshi H, Van Zyl J, Patlolla S, Salem M, Afzal A, Al-Saffar F, Hall SA. Safety and efficacy of ProtekDuo right ventricular assist device: A systemic review. Artif Organs 2023. [PMID: 37012224 DOI: 10.1111/aor.14525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 01/04/2023] [Accepted: 03/12/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Right ventricular failure is associated with increased morbidity and mortality. The ProtekDuo (Livanova, Uk) is a dual-lumen cannula that allows for percutaneous right ventricular support and may be connected to a centrifugal blood pump such as the TandemHeart or LifeSparc (Livanova, UK). This systematic review aims to evaluate the safety and efficacy of ProtekDuo right ventricular support and evaluate potential clinical variables that can influence outcomes. METHODS PubMed, MEDLINE, SCOPUS, EMBASE, and the Cochrane Library were systematically searched. Studies meeting inclusion criteria, where ProtekDuo was used as the right ventricular assist device with reported numerical death counts for mortality as outcome measures. The primary endpoints were in-hospital 30-day and 1-year mortality rates. Secondary endpoints included ICU length of stay, conversion rates to surgical RVADs, ProtekDuo wean rates, duration of use of ProtekDuo, and adverse event rates. RESULTS Of 49 studies reviewed, 7 met inclusion criteria with study periods between October 2014 and November 2019. ProtekDuo was utilized due to RV failure post-LVAD insertion in 64.8% (68/105) of patients. In-hospital mortality, 30-day mortality, and 1-year mortality ranged between 9%-46%, 15%-40%, and 19%-40%, respectively. Weaning from ProtekDuo and conversion to surgical RVAD ranged between 24%-91% and 11%-35%, respectively. The ICU stay average ranged from 15.8 to 36 days and ProtekDuo mean support duration ranged from 10.5 to 58 days. CONCLUSION The ProtekDuo cannula is increasingly utilized as a right ventricular support device. Despite the sparse retrospective data available with variable patient characteristics and study design, percutaneous RV mechanical support via ProtekDuo cannula is a safe and feasible option.
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Affiliation(s)
- Amit Alam
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
- Texas A&M University College of Medicine, Dallas, Texas, USA
| | - David A Baran
- Cleveland Clinic Heart, Vascular and Thoracic Institute, Weston, Florida, USA
| | - Harsh Doshi
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Johanna Van Zyl
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
| | - Srikant Patlolla
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
| | - Mahmoud Salem
- University of Pittsburg Medical Center, Harrisburg, Pennsylvania, USA
| | - Aasim Afzal
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
- Texas A&M University College of Medicine, Dallas, Texas, USA
| | - Farah Al-Saffar
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
- Texas A&M University College of Medicine, Dallas, Texas, USA
| | - Shelley A Hall
- Center for Advanced Heart Failure and Transplant Cardiology, Baylor University Medical Center, Texas, Dallas, USA
- Texas A&M University College of Medicine, Dallas, Texas, USA
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Rodenas-Alesina E, Brahmbhatt DH, Rao V, Salvatori M, Billia F. Prediction, prevention, and management of right ventricular failure after left ventricular assist device implantation: A comprehensive review. Front Cardiovasc Med 2022; 9:1040251. [PMID: 36407460 PMCID: PMC9671519 DOI: 10.3389/fcvm.2022.1040251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/18/2022] [Indexed: 08/26/2023] Open
Abstract
Left ventricular assist devices (LVADs) are increasingly common across the heart failure population. Right ventricular failure (RVF) is a feared complication that can occur in the early post-operative phase or during the outpatient follow-up. Multiple tools are available to the clinician to carefully estimate the individual risk of developing RVF after LVAD implantation. This review will provide a comprehensive overview of available tools for RVF prognostication, including patient-specific and right ventricle (RV)-specific echocardiographic and hemodynamic parameters, to provide guidance in patient selection during LVAD candidacy. We also offer a multidisciplinary approach to the management of early RVF, including indications and management of right ventricular assist devices in this setting to provide tools that help managing the failing RV.
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Affiliation(s)
- Eduard Rodenas-Alesina
- Mechanical Circulatory Support Program, Peter Munk Cardiac Center, University Health Network, Toronto, ON, Canada
- Ted Roger’s Center for Heart Research, University Health Network, Toronto, ON, Canada
- Department of Cardiology, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Darshan H. Brahmbhatt
- Mechanical Circulatory Support Program, Peter Munk Cardiac Center, University Health Network, Toronto, ON, Canada
- Ted Roger’s Center for Heart Research, University Health Network, Toronto, ON, Canada
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Vivek Rao
- Mechanical Circulatory Support Program, Peter Munk Cardiac Center, University Health Network, Toronto, ON, Canada
- Ted Roger’s Center for Heart Research, University Health Network, Toronto, ON, Canada
| | - Marcus Salvatori
- Department of Anesthesia, University Health Network, Toronto, ON, Canada
| | - Filio Billia
- Mechanical Circulatory Support Program, Peter Munk Cardiac Center, University Health Network, Toronto, ON, Canada
- Ted Roger’s Center for Heart Research, University Health Network, Toronto, ON, Canada
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Bhatia M, Jia S, Smeltz A, Kumar PA. Right Heart Failure Management: Focus on Mechanical Support Options. J Cardiothorac Vasc Anesth 2022; 36:3278-3288. [DOI: 10.1053/j.jvca.2022.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/11/2022]
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Vaile JR, Rame JE, Alvarez RJ, Massey HT, Tchantchaleishvili V, Vishnevsky A, Rajapreyar IN, Brailovsky Y, Shah MK. 3 Cases of Superior Vena Cava Syndrome Following Percutaneous Right Ventricular Assist Device Placement. JACC Case Rep 2021; 3:1690-1693. [PMID: 34766020 PMCID: PMC8571785 DOI: 10.1016/j.jaccas.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/09/2021] [Accepted: 09/17/2021] [Indexed: 11/26/2022]
Abstract
We present 3 cases of superior vena cava (SVC) syndrome following percutaneous right ventricular assist device (RVAD) placement. Each case underscores the importance of early recognition of SVC syndrome in patients with percutaneous RVAD insertion via the internal jugular vein and calls for heightened awareness of device-associated complications. (Level of Difficulty: Advanced.)
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Affiliation(s)
- John R Vaile
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - J Eduardo Rame
- Department of Heart Failure and Transplant, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Rene J Alvarez
- Department of Heart Failure and Transplant, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Howard T Massey
- Department of Cardiothoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | | | - Alec Vishnevsky
- Department of Interventional and Structural Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Indranee N Rajapreyar
- Department of Heart Failure and Transplant, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Yevgeniy Brailovsky
- Department of Heart Failure and Transplant, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Mahek K Shah
- Department of Heart Failure and Transplant, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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