Preparation and Technical Considerations for Percutaneous Cannulation for Veno-Arterial Extracorporeal Membrane Oxygenation

• Published in: Journal of cardiac surgery Vol. 28; no. 2; pp. 190 - 192
• Main Authors: Lamb, Kathleen M., Hirose, Hitoshi, Cavarocchi, Nicholas C.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-03-2013
• Subjects: Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - methods; Extracorporeal Membrane Oxygenation - adverse effects; Extracorporeal Membrane Oxygenation - instrumentation; Extracorporeal Membrane Oxygenation - methods; Femoral Vein; Humans; Intraoperative Complications - prevention & control; Ischemia - etiology; Ischemia - prevention & control; Leg - blood supply
• ISSN: 0886-0440; 1540-8191
• DOI: 10.1111/jocs.12058

Background
The most frequent limb complications from peripheral veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.
Technique
Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA‐ECMO, distal limb perfusion was monitored using near‐infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site.
Conclusions
Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding. doi: 10.1111/jocs.12058 (J Card Surg 2013;28:190–192)