Right ventricular rupture and tamponade caused by malposition of the Avalon cannula for venovenous extracorporeal membrane oxygenation

Journal of Cardiothoracic Surgery

Nicholas Cavarocchi²  Gregary Marhefka¹  Kentaro Yamane²  Hitoshi Hirose² 

[1] Department of Medicine, Division of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA;Department of Surgery, Division of Cardiothoracic Surgery, Thomas Jefferson University, Philadelphia, PA, USA

关键词: Respiratory failure;    Pneumonia;    Surgery;    Tamponade;    ECMO;   

Others  :  1153303
DOI  :  10.1186/1749-8090-7-36

 received in 2011-10-19, accepted in 2012-04-20,  发布年份 2012

【 摘 要 】

Placement of the Avalon Elite bicaval dual lumen cannula for venovenous extracorporeal membrane oxygenation (VV-ECMO) via the internal jugular vein requires precise positioning of the cannula tip in the inferior vena cava with echocardiography or fluoroscopy guidance. Correct guidewire placement is clearly the key first step in assuring proper advancement of the cannula. We report a case of unexpected wire migration into the right ventricle at the time of final cannula advancement, resulting in right ventricular rupture and tamponade. Transesophageal echocardiography is an important monitoring modality for appropriate placement of the VV-ECMO guidewire and Avalon cannula, and in particular, for early identification of potential complications.

【 授权许可】

   
2012 Hirose et al; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Bermudez CA, Rocha RV, Sappington PL, Toyoda Y, Murray HN, Boujoukos AJ: Initial experience with single cannulation for venovenous extracorporeal oxygenation in adults. Ann Thorac Surg 2010, 90:991-995.
• [2]Javidfar J, Brodie D, Wang D, et al.: Use of bicavaldual-lumencatheter for adult venovenous extracorporeal membrane oxygenation. Ann Thorac Surg 2011, 91:1763-1768.