The ProtekDuo® veno-venous (V-V) dual lumen cannula permits a form of extracorporeal mechanical circulatory support using an oxygenator and, when combined with a TandemHeart® pump, can deliver close to 4 liters/minute of flow allowing the right side of the heart to rest while right-to-left flow is augmented.
The cannula (29 or 31 French in diameter!) is inserted percutaneously using the Seldinger technique in the right internal jugular (IJ) vein with its inflow usually in the right atrium (RA) and outflow situated in the main pulmonary artery (PA). Placement of this cannula can be facilitated by using a flow-directed pulmonary artery catheter (PAC or “Swan-Ganz” catheter) followed by threading in a .035 Lunderquist® guidewire. Correct positioning is confirmed with echocardiography, transduction of intracardiac pressures on the PAC, and/or fluoroscopy.
The best part of this configuration (cannula in the neck, portable pump) is that the patient can ambulate and carry his/her pump around! As always, drop me a comment with questions below! 🙂