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Migrated Avalon Veno‐Venous Extracorporeal Membrane Oxygenation Cannula: How to Adjust Without Interruption of Flow
Author(s) -
Tanaka Daizo,
Pitcher Harrison T.,
Cavarocchi Nicholas,
Hirose Hitoshi
Publication year - 2015
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12629
Subject(s) - medicine , cannula , extracorporeal membrane oxygenation , fluoroscopy , surgery , femoral vein , lumen (anatomy) , anesthesia
A BSTRACT The Avalon dual lumen cannula is presently the cannula of choice for veno‐venous extracorporeal membrane oxygenation (VV‐ECMO) via right internal jugular cannulation. This cannula establishes VV‐ECMO with a single cannulation; however, it requires appropriate positioning to gain adequate oxygenation. Malposition of this cannula can cause inadequate ECMO flow, hypoxia, and structural injury. We have experienced two cases of migration: one into the hepatic vein and the other into the right ventricle. The former was repositioned using echocardiographic guidance without using a guidewire. The latter was repositioned using a guidewire from the femoral vein under fluoroscopy, without antegrade wire placement into the Avalon cannula, discontinuation of ECMO, or bleeding.