Aggarwal Vikas, Einhorn Bryce N, Cohen Howard A
Division of Cardiology (Interventional Cardiology), Department of Internal Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
Temple University School of Medicine, Philadelphia, Pennsylvania.
Catheter Cardiovasc Interv. 2016 Sep;88(3):390-6. doi: 10.1002/ccd.26348. Epub 2016 Feb 20.
Ventricular assist devices have become an accepted therapeutic solution for patients with severe left ventricular dysfunction when pharmacology fails to maintain sufficient cardiac output. Despite various technologies that have allowed left ventricular assist devices to become more reliable and versatile in the past decade, comparatively little attention has been applied to right heart assistance which is still in the early stage of its development. The extracorporeal devices developed thus far have been associated with mobility issues and complications common to ventricular assist devices in general, such as infection, bleeding, and thromboembolism. Designed to obviate the problems previously experienced by other right ventricle (RV)-focused devices, the Protek Duo (CardiacAssist, Pittsburgh, PA) is a novel, fully percutaneous, dual lumen cannula for RV support used in conjunction with the paracorporeal TandemHeart(®) (CardiacAssist, Pittsburgh, PA) pump. We describe our initial experience with the Protek Duo cannula in two different clinical scenarios. In addition, we summarize the current percutaneous mechanical support technology for RV assistance and propose modification of current technology to facilitate its application. © 2016 Wiley Periodicals, Inc.
当药物治疗无法维持足够的心输出量时,心室辅助装置已成为重度左心室功能不全患者公认的治疗解决方案。尽管在过去十年中,各种技术使左心室辅助装置变得更加可靠和通用,但右心辅助仍处于发展初期,相对而言受到的关注较少。迄今为止开发的体外装置与心室辅助装置常见的移动性问题和并发症有关,如感染、出血和血栓栓塞。Protek Duo(宾夕法尼亚州匹兹堡市CardiacAssist公司)是一种新型的、完全经皮的双腔插管,用于右心室支持,与体外串联式人工心脏(®)(宾夕法尼亚州匹兹堡市CardiacAssist公司)泵联合使用,旨在避免其他以右心室(RV)为重点的装置以前遇到的问题。我们描述了在两种不同临床场景中使用Protek Duo插管的初步经验。此外,我们总结了目前用于右心室辅助的经皮机械支持技术,并提出对现有技术进行改进以促进其应用。© 2016威利期刊公司