First Successful Use of 2 Axial Flow Catheters for Percutaneous Biventricular Circulatory Support as a Bridge to a Durable Left Ventricular Assist Device

During the past 2 decades, the use of durable mechanical circulatory support (MCS) for advanced heart failure has grown exponentially, in large part, because of clinical trials demonstrating improved rates of survival when compared with medical therapy alone.1 Among patients referred for durable MCS implantation, 2 major predictors of poor survival include (1) clinical instability identified as Interagency for Mechanically Assisted Circulatory Support profiles 1 or 2 and (2) preoperative right ventricular failure.2,3 Right ventricular failure also currently prohibits the use of durable MCS as a destination therapy option. In parallel to growth in durable MCS implants, nondurable or percutaneous MCS device use has also increased since 2007.4 No reports have described the use of percutaneously delivered axial flow catheters to fully support both right and left ventricular (LV) functions before durable MCS implantation. We describe a case illustrating the potential use of axial flow catheters to support a patient with cardiogenic shock caused by biventricular failure (BiVF).A 45-year-old man with stage D ischemic cardiomyopathy and a LV ejection fraction of 10%, moderate RV dysfunction, and moderate tricuspid regurgitation presents with 1 month …