4.2 Article

Right Ventricular Failure Manifesting in Corona Virus Disease 2019 Acute Respiratory Distress Syndrome: A Call to Transition from Venovenous Extracorporeal Membranous Oxygenation to Right Ventricular Assist Device Extracorporeal Membranous Oxygenation

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.jvca.2022.02.026

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right ventricular assist device; extracorporeal membranous oxygenation; COVID-19; ProtekDuo; acute respiratory distress syndrome

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The importance of the right ventricle (RV) has been magnified due to the exacerbation of RV failure caused by severe acute respiratory syndrome coronavirus 2 infection. Venovenous extracorporeal membranous oxygenation (VV-ECMO) has become a main treatment for severe COVID-19 acute respiratory distress syndrome, and early implementation of a right ventricular assist device may improve patient outcomes.
Often labeled the forgotten ventricle, the right ventricle's (RV) importance has been magnified over the last 2 years as providers witnessed how severe acute respiratory syndrome coronavirus 2 infection has a predilection for exacerbating RV failure. Venovenous extracorporeal membranous oxygenation (VV-ECMO) has become a mainstay treatment modality for a select patient population suffering from severe COVID-19 acute respiratory distress syndrome. Concomitant early implementation of a right ventricular assist device with ECMO (RVAD-ECMO) may confer benefit in patient outcomes. The underlying mechanism of RV failure in COVID-19 has a multifactorial etiopathogenesis; nonetheless, clinical evaluation of a patient necessitating RV support remains unchanged. Herein, the authors report the case of a critically ill patient who was transitioned from a conventional VV-ECMO Medtronic Crescent cannula to RVAD-ECMO, with the insertion of the LivaNova ProtekDuo dual-lumen RVAD cannula. Published by Elsevier Inc.

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