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Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report

  • Ga Young Yoo (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • June Lee (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Seok Beom Hong (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Do Yeon Kim (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2023.09.21
  • 심사 : 2023.11.21
  • 발행 : 2024.05.05

초록

Venovenous extracorporeal membrane oxygenation (VV ECMO) is often used in cases of severe respiratory failure, especially in patients considered for lung transplantation. However, because many lung diseases can ultimately result in right heart failure, the treatment of secondary right heart failure can present a challenge when the patient is already under VV ECMO support. In such cases, an oxygenated-right ventricular assist device (OxyRVAD) can be used. OxyRVAD is designed to maintain anterograde blood flow and prevent right ventricular distension. Moreover, the pulmonary arterial cannula can be inserted percutaneously. We report a case in which percutaneous OxyRVAD was successfully implemented to manage right heart failure in a patient with respiratory failure who was on VV ECMO.

키워드

참고문헌

  1. Yeo HJ, Lee S, Yoon SH, et al. Extracorporeal life support as a bridge to lung transplantation in patients with acute respiratory failure. Transplant Proc 2017;49:1430-5. https://doi.org/10.1016/j.transproceed.2017.02.064
  2. Jayaraman AL, Cormican D, Shah P, Ramakrishna H. Cannulation strategies in adult veno-arterial and veno-venous extracorporeal membrane oxygenation: techniques, limitations, and special considerations. Ann Card Anaesth 2017;20(Supplement):S11-8. https://doi.org/10.4103/0971-9784.197791
  3. Yeo HJ, Yoon SH, Jeon D, et al. The utility of preemptive distal perfusion cannulation during peripheral venoarterial extracorporeal membrane oxygenation support. J Interv Cardiol 2016;29:431-6. https://doi.org/10.1111/joic.12309
  4. Yeo HJ, Jeon D, Kim YS, Cho WH, Kim D. Veno-veno-arterial extracorporeal membrane oxygenation treatment in patients with severe acute respiratory distress syndrome and septic shock. Crit Care 2016;20:28. https://doi.org/10.1186/s13054-016-1205-9
  5. Makdisi G, Wang IW. Extra corporeal membrane oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis 2015;7:E166-76. https://doi.org/10.3978/j.issn.2072-1439.2015.07.17
  6. Bunge JJ, Caliskan K, Gommers D, Reis Miranda D. Right ventricular dysfunction during acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation. J Thorac Dis 2018;10(Suppl 5):S674-82. https://doi.org/10.21037/jtd.2017.10.75
  7. Noly PE, Kirsch M, Quessard A, et al. Temporary right ventricular support following left ventricle assist device implantation: a comparison of two techniques. Interact Cardiovasc Thorac Surg 2014;19:49-55. https://doi.org/10.1093/icvts/ivu072
  8. Mohite PN, Patil NP, Popov AF, Bahrami T, Simon AR. Oxygenator in short-term LVAD circuit: a rescue in post-LVAD pulmonary complications. Perfusion 2016;31:608-10. https://doi.org/10.1177/0267659115627691
  9. Sim JK, Jeon K, Suh GY, Chung S, Cho YH. Successful lung transplantation after 213 days of extracorporeal life support: role of oxygenator-right ventricular assist device. ASAIO J 2021;67:e127-30. https://doi.org/10.1097/MAT.0000000000001324
  10. Oh DK, Shim TS, Jo KW, et al. Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation. Acute Crit Care 2020;35:117-21. https://doi.org/10.4266/acc.2018.00416
  11. Lee SK, Kim DH, Cho WH, Yeo HJ. Oxy-right ventricular assist device for bridging of right heart failure to lung transplantation. Transplantation 2021;105:1610-4. https://doi.org/10.1097/TP.0000000000003459
  12. Park I, Cho YH, Chung SR, et al. Temporary right ventricular assist device insertion via left thoracotomy after left ventricular assist device implantation. Korean J Thorac Cardiovasc Surg 2019;52:105-8. https://doi.org/10.5090/kjtcs.2019.52.2.105
  13. Lepper PM, Horsch SI, Seiler F, et al. Percutaneous mechanical circulation support combined with extracorporeal membrane oxygenation (oxyRVAD) in secondary right heart failure. ASAIO J 2018;64:e64-7. https://doi.org/10.1097/MAT.0000000000000754