SHM Converge Scientific Abstract ePoster Gallery-Bi-Ventricular Cardiac Support With v-Pa Ecmo Using Lvad and Prvad in a Patient With Situs Inversus Totalis

Pdf Summary

This case report describes a 24-year-old woman with situs inversus totalis, obesity, and stage D non-ischemic dilated cardiomyopathy who previously survived ventricular fibrillation cardiac arrest and had a dual-chamber ICD placed. She was maintained on home inotrope therapy while awaiting left ventricular assist device (LVAD) implantation.<br /><br />She underwent HeartMate III LVAD placement via full sternotomy. After surgery, she initially improved but developed signs of right ventricular failure, including elevated carbon dioxide levels, worsening hemodynamics, and reduced urine output. On postoperative day 2, she required reintubation and placement of a 29F ProtekDuo cannula for temporary right ventricular mechanical support (pRVAD), along with additional medical management such as BiPAP, epoprostenol, and diuretics.<br /><br />Her condition improved steadily over the next several days. The ProtekDuo cannula was removed on postoperative day 6, and by day 7 she was stable and weaning to minimal inotropic support while awaiting transplant candidacy assessment. She was discharged home on postoperative day 16. At follow-up, she had no heart failure symptoms and had returned to work.<br /><br />The report emphasizes that LVAD therapy is now standard for end-stage heart failure, but right ventricular failure remains a common complication after implantation. In patients with situs inversus totalis, altered anatomy requires special attention to cannulation and device positioning. This case demonstrates that with careful planning and multidisciplinary collaboration, advanced mechanical circulatory support—including LVAD and temporary RVAD with ProtekDuo—can be successfully used even in complex congenital anatomy.

Asset Subtitle

Zain Khan

Meta Tag

Author List Asif Saberi, Blake Callahan, Zain Khan

Category Clinical Vignettes

Concept Situs Inversus Totalis

Concept Left Ventricular Assist Device

Concept Right-Sided Failure

Concept Mechanical Circulatory Support

Concept End-Stage Dilated Cardiomyopathy

Distinguished Non-Finalist

Presenter Organization Wellstar Kennestone Internal Medicine

Presenting Author Zain Khan

Track Adult

Keywords

situs inversus totalis

left ventricular assist device

HeartMate III

right ventricular failure

ProtekDuo cannula

temporary RVAD

dilated cardiomyopathy

ventricular fibrillation

mechanical circulatory support

heart failure

Situs Inversus Totalis

Left Ventricular Assist Device

Right-Sided Failure

Mechanical Circulatory Support

End-Stage Dilated Cardiomyopathy