Comment
Functional improvement of the RV after normalization of loading
conditions under the support of temporary RVAD systems has been
described but were rarely used in cases of isolated acute-on-chronic
s-RVF due to rapidly exacerbated PAH and is still
controversial.4, 5 Despite an
extremely high PAP in our patient, we saw no signs of pulmonary edema or
hemorrhage.
This case demonstrates a successful two-step treatment of a patient with
acute-on-chronic RVF due to severe primary PAH with implantation of a
percutaneous RVAD system combined with a regular veno-arterial ECMO
set-up for biventricular support in on-going resuscitation which may be
a safe and feasible treatment for patients with these critical clinical
conditions, however, further clinical investigation is required.