Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

Takashi Harano; Ernest G Chan; Masashi Furukawa; Pedro Reck Dos Santos; Matthew R Morrell; Penny L Sappington; Pablo G Sanchez

doi:10.21037/jtd-21-1199

Oxygenated right ventricular assist device with a percutaneous dual-lumen cannula as a bridge to lung transplantation

J Thorac Dis. 2022 Apr;14(4):832-840. doi: 10.21037/jtd-21-1199.

Authors

Takashi Harano^{1

2}, Ernest G Chan¹, Masashi Furukawa¹, Pedro Reck Dos Santos¹, Matthew R Morrell³, Penny L Sappington⁴, Pablo G Sanchez¹

Affiliations

¹ Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
² Division of Thoracic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁴ Department of Medicine, West Virginia University, Morgantown, WV, USA.

Abstract

Background: Oxygenated right ventricular assist device (oxyRVAD) placement has become more streamlined with the introduction of the dual-lumen pulmonary artery cannula. Peripherally cannulated oxyRVAD may provide oxygenation support with right heart support as an alternative to venoarterial extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation.

Methods: A single-institution, retrospective analysis was performed on patients placed on oxyRVAD with a dual-lumen pulmonary artery cannula with the intention of bridging to lung transplantation in 2019.

Results: Four patients with idiopathic pulmonary fibrosis were placed on oxyRVAD as a bridge to transplantation. Two patients were extubated and ambulated while waiting for a lung offer, and two patients required conversion to venoarteriovenous ECMO (VAV ECMO) from oxyRVAD. The median waiting time for extracorporeal life support (ECLS) was 42 h. All patients underwent double lung transplantation. Two patients stayed on oxyRVAD, and one patient was placed on venovenous ECMO (VV ECMO) after transplantation. Primary graft dysfunction score at 72 h after transplantation was grade 1 in three patients and grade 3 in one patient.

Conclusions: Peripherally cannulated oxyRVAD with percutaneous dual-lumen venous cannula could be an ambulatory bridge for lung transplantation. It is unknown whether oxyRVAD is feasible as a long-term bridge to lung transplantation.

Keywords: Oxygenated right ventricular assist device (oxyRVAD); bridge to lung transplantation; dual-lumen pulmonary artery cannula; extracorporeal membrane oxygenation (ECMO).