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Femoral venoarterial extracorporeal membrane oxygenation using a novel biatrial cannula for venous drainage and left ventricular venting
Author(s) -
OrozcoHernandez Erik J.,
Ahmed Mustafa I.,
Von Meering Greg,
Mcelwee Samuel K.,
Prejean Shane P.,
Gongora Enrique,
Hoopes Charles W.
Publication year - 2020
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.15087
Subject(s) - medicine , extracorporeal membrane oxygenation , cardiogenic shock , cannula , ventricular assist device , cardiology , extracorporeal , percutaneous , impella , life support , ventricle , distension , surgery , anesthesia , heart failure , myocardial infarction , intensive care medicine
Abstract Extracorporeal life support (ECLS) is an expanding technology for patients in cardiogenic shock. The majority of patients requiring ECLS can be managed with percutaneous venoarterial (VA) femoral cannulation. Despite sufficient extracorporeal circulatory support, a unclear number of patients develop left ventricular distension which can result in increased wall tension and stress as well as worsening pulmonary edema. Indications to vent the left ventricle can be controversial. When venting is indicated, a number of additional procedures may be considered including inotropic support, intra‐aortic balloon pump, impella, balloon atrial septostomy, or placement of a transseptal cannula. We present a unique case of a femoral VA extracorporeal membrane oxygenation as a bridge to transplant with left‐sided venting using a Bio‐Medicus NextGen cannula (Medtronic) with a transseptal approach.