The ProtekDuo dual-lumen cannula allows percutaneous support in right ventricular failure with or without gas exchange impairments. However, positioning of the device is resource demanding. The usual approach requires a fluoroscopy–equipped operating room, possibly limiting its wider and timely adoption. We report our initial experience with bedside, fluoroless ProtekDuo implantation under transesophageal echocardiography (TEE) guidance in a tertiary care national referral center. Eight critically ill patients underwent bedside ProtekDuo placement for right ventricular dysfunction or acute respiratory distress syndrome with right ventricular failure. All procedures were completed successfully without procedural complications. Our findings demonstrate that bedside, TEE-guided, fluoroless ProtekDuo cannulation is feasible and safe, potentially expanding access to advanced mechanical circulatory support.</p
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