Right Ventricular Mechanical Support With ProtekDuo Cannula as a Bridge to Recovery After Post-Infarction Ventricular Septal Defect Repair

Post–myocardial infarction ventricular septal defect is a catastrophic mechanical complication frequently associated with acute right ventricular failure and high mortality. Veno-arterial extracorporeal membrane oxygenation (ECMO) is commonly used for temporary circulatory support; however, persistent left-to-right shunting and severe right ventricular dysfunction may limit successful myocardial recovery. We report the use of prolonged isolated right ventricular mechanical support with the ProtekDuo cannula in a patient with inferior myocardial infarction complicated by ventricular septal defect and refractory cardiogenic shock. After unsuccessful surgical repair and inability to wean from prolonged ECMO support, the patient was transitioned to ProtekDuo-based right ventricular assist support using a centrifugal pump. This approach resulted in hemodynamic stabilization, withdrawal of veno-arterial support, and reduced vasoactive requirements. Right ventricular assist support was maintained for 51 consecutive days without device-related complications, allowing myocardial recovery and enabling subsequent percutaneous closure of the residual septal defect. Successful weaning from mechanical circulatory support was achieved after a total of 77 days. To our knowledge, this represents one of the longest reported durations of isolated right ventricular support using the ProtekDuo system. This case supports the feasibility and durability of prolonged ProtekDuo right ventricular assistance as a bridge to recovery in complex post-infarction complications.