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

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          Abstract

          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.

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          Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology.

          George Makdisi, I-Wen Wang (2015)
          Extra Corporeal Membrane Oxygenation (ECMO) indications and usage has strikingly progressed over the last 20 years; it has become essential tool in the care of adults and children with severe cardiac and pulmonary dysfunction refractory to conventional management. In this article we will provide a review of ECMO development, clinical indications, patients' management, options and cannulations techniques, complications, outcomes, and the appropriate strategy of organ management while on ECMO.
          Article 0 comments Cited 139 times – based on 0 reviews     Review now
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            Cannulation Strategies in Adult Veno-arterial and Veno-venous Extracorporeal Membrane Oxygenation: Techniques, Limitations, and Special Considerations

            Arun L Jayaraman, Daniel S Cormican, Pranav Shah … (2017)
            Extracorporeal membrane oxygenation (ECMO) refers to specific mechanical devices used to temporarily support the failing heart and/or lung. Technological advances as well as growing collective knowledge and experience have resulted in increased ECMO use and improved outcomes. Veno-arterial (VA) ECMO is used in selected patients with various etiologies of cardiogenic shock and entails either central or peripheral cannulation. Central cannulation is frequently used in postcardiotomy cardiogenic shock and is associated with improved venous drainage and reduced concern for upper body hypoxemia as compared to peripheral cannulation. These concerns inherent to peripheral VA ECMO may be addressed through so-called triple cannulation approaches. Veno-venous (VV) ECMO is increasingly employed in selected patients with respiratory failure refractory to more conventional measures. Newer dual lumen VV ECMO cannulas may facilitate extubation and mobilization. In summary, the pathology being addressed impacts the ECMO approach that is deployed, and each ECMO implementation has distinct virtues and drawbacks. Understanding these considerations is crucial to safe and effective ECMO use.
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              Right ventricular dysfunction during acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation.

              Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers … (2018)
              Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined. The beneficial effect of veno-venous (VV) ECMO on RV function in these patients will be illustrated. Based on this, we will give recommendations regarding choice of ECMO modus and provide an algorithm for management of RV failure in VV ECMO supported patients.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Chest Surg
                Journal ID (iso-abbrev): J Chest Surg
                Title: Journal of Chest Surgery
                Publisher: The Korean Society for Thoracic and Cardiovascular Surgery
                ISSN (Print): 2765-1606
                ISSN (Electronic): 2765-1614
                Publication date (Print): 5 May 2024
                Publication date (Electronic): 16 January 2024
                Publication date PMC-release: 16 January 2024
                Volume: 57
                Issue: 3
                Pages: 319-322
                Affiliations
                [1]Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
                Author notes
                Corresponding author Do Yeon Kim Tel 82-2-2258-6133 Fax 82-2-594-8644 E-mail goodmd77@ 123456catholic.ac.kr ORCID https://orcid.org/0000-0001-5179-7257
                Author information
                https://orcid.org/0000-0002-5066-3270
                https://orcid.org/0000-0002-3889-069X
                https://orcid.org/0009-0008-4603-7438
                https://orcid.org/0000-0001-5179-7257
                Article
                Publisher ID: jcs-57-3-319
                DOI: 10.5090/jcs.23.132
                PMC ID: 11089057
                PubMed ID: 38225830
                SO-VID: 8f29fa9e-4a9d-4278-8d33-6e5de4aefdaf
                Copyright © Copyright © 2024, The Korean Society for Thoracic and Cardiovascular Surgery
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 September 2023
                Date revision received : 6 November 2023
                Date accepted : 21 November 2023
                Funding
                Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
                Categories
                Subject: Case Report

                Keywords: oxygenated-right ventricular assist device,right heart failure,extracorporeal membrane oxygenation,case reports
                Data availability:
                Keywords: oxygenated-right ventricular assist device, right heart failure, extracorporeal membrane oxygenation, case reports

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