Percutaneous versus open cannulation for mechanical support in patients with right ventricular failure after left ventricular assist device placement

Abstract

Aim: Temporary right ventricular assist device (t-RVAD) is an option for those patients in right ventricular failure (RVF) after left ventricular assist device (LVAD) resistant to ionotropic therapy. There are two options to placing a t-RVAD: an open, central technique or a percutaneous placement with Protek Duo® cannula. Methods: We compare these two t-RVAD devices that treat RVF after LVAD placement. Between 2013–2019, 22 patients were identified needing t-RVAD support after LVAD placement. Fourteen patients had open/central while 8 patients had percutaneous right ventricular assist device (RVAD) support. Results: There was no difference in length of ICU stay (49 ± 32 days Protek Duo® vs. 45 ± 22 days “open”; P = 0.73); hospital length of stay (57 ± 39 days vs. 55 ± 28 days; P = 0.088); discharge from ICU and hospital (62.1% Protek Duo® vs. 57% for “open”; P = 0.9 for both); or the one-year survival between the two groups (62% Protek Duo® vs. 50% “open”; P = 0.67). The Protek Duo® group had less total time on the ventilator (15 ± 9 days vs. 27 ± 17 days; P = 0.044) and required less amount of blood products (17 ± 8.9 units RBC and 2.0 ± 1.91 units FFP vs. 31 ± 20.5 units RBC and 11.5 ± 10 units FFP; P = 0.046 and P = 0.005). Conclusions: Percutaneous t-RVAD support is a viable option for patients whom undergo LVAD placement and require right ventricular mechanical support.