The First Local Experience of Use of Extracorporeal Circulatory Support with PROTEKDuo Dual-Lumen Cannula in a Patient with Acute Right Ventricular Failure

Oleksandr M. Dovgan, Maksim E. Paulouski, Alona I. Honcharenko, Anton V. Makedon, Y. V. Prystaia
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Abstract

Acute right ventricular failure is a life-threatening condition that can occur as a result of a sudden increase in total pulmonary vascular resistance, in particular, as a result of pulmonary embolism. Most patients with thromboembolism are treated with thrombolytic therapy, but in some cases open thrombextraction is preferred. Removal of blood clots from the pulmonary vascular bed and cardiopulmonary bypass can lead to spasm of the pulmonary artery and to the elevation of total pulmonary resistance, which, in turn, increases the afterload on the right ventricle and can lead to a dramatic decrease in its mechanical function. The aim. The aim of this report is to present the first experience of using the right ventricular bypass with the PROTEKDuo cannula for the purpose of temporary mechanical support of the right ventricle. Case presentation. We studied a 63-year-old patient who underwent Studer technique for bladder adenocarcinoma. On the 14th day an acute massive pulmonary embolism occurred with a drop in hemodynamics and the presence of a floating clot on the right atrium. Thrombolysis carried significant risks due to possible bleeding and clot fragmentation in the right atrium with subsequent embolization of the pulmonary arteries. In these circumstances, open thrombectomy under hypothermic arrest was performed. Intraoperatively, the patient developed acute right ventricular failure resistant to all conservative therapy, therefore, right ventricular bypass was connected using PROTEKDuo, which made it possible to overcome the phenomena of acute right ventricular failure in the postoperative period. Conclusions. Our experience with right ventricular bypass using the PROTEKDuo dual-lumen cannula demonstrates another useful option for saving patients with isolated right ventricular failure.
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PROTEKDuo双腔插管应用体外循环支持治疗急性右心室衰竭的首次局部经验
急性右心室衰竭是一种危及生命的疾病,可由于肺血管总阻力的突然增加而发生,特别是由于肺栓塞。大多数血栓栓塞患者采用溶栓治疗,但在某些情况下,开放血栓提取是首选。从肺血管床清除血块和体外循环可导致肺动脉痉挛和肺总阻力升高,这反过来又增加了右心室的后负荷,并可导致其机械功能急剧下降。的目标。本报告的目的是介绍首次使用PROTEKDuo套管进行右心室旁路的经验,目的是为右心室提供临时机械支持。案例演示。我们研究了一位63岁的患者,他接受了膀胱腺癌的Studer技术。第14天发生急性大面积肺栓塞,血流动力学下降,右心房出现浮动凝块。由于右心房可能出现出血和血栓碎裂,随后肺动脉栓塞,溶栓具有显著的风险。在这种情况下,在低温停搏下进行切开取栓。术中患者出现急性右心室衰竭,对所有保守治疗均无效,因此采用PROTEKDuo连接右心室旁路,克服了术后急性右心室衰竭的现象。结论。我们使用PROTEKDuo双腔插管进行右心室旁路的经验表明,这是拯救孤立性右心室衰竭患者的另一种有效选择。
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来源期刊
CiteScore
0.20
自引率
0.00%
发文量
42
审稿时长
6 weeks
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