Right ventricular assist devices for mechanical circulatory support in acute massive pulmonary embolism: a single centre experience

Background: Mechanical circulatory support may be considered in patients with severe acute right ventricular (RV) failure due to massive pulmonary embolism (PE). Method: We report outcomes in consecutive patients referred to our ECMO service for acute PE complicated by cardiogenic shock and received a percutaneous right ventricular assist device (pRVAD) between December 2019 and December 2020. Results: Four patients (mean age 49±15 yrs) with persistent cardiogenic shock and severe RV failure from acute PE received Protek Duo Oxy-RVADs. Haemodynamic status and RV function improved with pRVAD support and all patients were decannulated after a mean duration of 8±2.9 days. There were no device-related complications. One patient died of hospital aquired pneumonia 15 days after decannulation. Conclusion: In this initial series of patients with PE related severe acute RV failure, pRVADs resulted in hemodynamic benefits with reversal of shock.