Minimally invasive insertion of off-pump central extracorporeal membrane oxygenation

Avery, Ryan; Yu, Soojie; Rao, Prashant; Wong, Raymond Woon Sing; Khalpey, Zain

doi:10.1111/jocs.13208

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…technique does allow for early extubation and ambulation, but bleeding from the axillary artery cannulation site can be problematic. Similar to minimally invasive approaches described by others, 3,4,8,9 our sternal-sparing approach provides versatility to easily reconfigure to LVAD/LVAD-ECMO, or BiVAD, using either additional venous cannula or a regular PROTEK Duo cannula via internal jugular vein. In BiVAD or ECMO configuration, the continuing need of additional venous cannulae or oxygenator can be assessed and removed if tolerated, usually bedside in the intensive care unit.…”

Section: Minimally Invasive Temporary E3mentioning

confidence: 89%

“…The back-table modification of cannula is not recommended due to increased risk of the cardiac/aortic valve and aortic injury. Avery et al 9 have also reported their minimally invasive technique using standard PROTEK Duo cannula, but an optimal placement of the drainage and return ports remain a challenge as the cannula length and design are not appropriate for LV transapical placement. The PROTEK Duo-RD cannula is primarily designed for rapid establishment of veno-venous ECMO.…”

Section: Commentmentioning

confidence: 99%

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Minimally Invasive Off-Pump Technique for Temporary Left Ventricular Support

2021

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Use of short-term mechanical circulatory support (MCS) for cardiogenic shock has rapidly increased. Most common initial MCS strategies entail institution of peripheral extracorporeal membrane oxygenation (ECMO) or temporary ventricular assist devices. For patients with anatomically small peripheral arteries or insufficient circulatory support, sternotomy and central cannulation techniques may be necessary. These invasive approaches are associated with increased risk of bleeding and other significant complications. We describe a minimally invasive, off-pump technique to provide adequate hemodynamic support and left ventricular unloading, allowing early postoperative ambulation, and ability to easily provide additional right ventricular/ ECMO support if needed.

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Section: Minimally Invasive Temporary E3mentioning

confidence: 89%

Section: Commentmentioning

confidence: 99%

Minimally Invasive Off-Pump Technique for Temporary Left Ventricular Support

2021

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“…Avery et al . [ 2 ] did not modify the length but found important challenges as the cannula length and design were not appropriate. There are a few reports of using PROTEK Duo-RD cannula.…”

Section: Discussionmentioning

confidence: 99%

“…Temporary mechanical circulatory support (MCS) utilization has expanded over the past decade in patients with cardiogenic shock and progressive end-organ injury [ 1 ]. Peripheral extracorporeal membrane oxygenation (ECMO), central ECMO and axillary Impella 5.5 are the common MCS that include significant invasive approach and the need for possible cardiopulmonary bypass [ 2 ]. We present a temporary left ventricular assist device (LVAD) using a transapical dual lumen cannula with novel technical modifications that improve postoperative management and safety [ 3–5 ].…”

Section: Introductionmentioning

confidence: 99%

A novel method of transapical ProtekDuo rapid deployment cannula as temporary left ventricular assist device

Ravipati,

Nooli,

Hoopes

et al. 2023

Journal of Surgical Case Reports

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Peripheral extracorporeal membrane oxygenation (ECMO) is one of the most common strategies for cardiogenic shock. ECMO cannulation is associated with an increased risk of complications. We describe a minimally invasive, off-pump technique to provide adequate hemodynamic support and left ventricular unloading. A 54-year-old male with nonischemic cardiomyopathy and severe peripheral vascular disease with cardiogenic shock was initially supported with inotropes and an intra-aortic balloon pump. Despite continued support, he continued to deteriorate, and we escalated to a temporary left ventricular support with a CentriMag, using a transapical ProtekDuo Rapid Deployment cannula via mini left-thoracotomy. This approach provides adequate hemodynamic support, left ventricular unloading and early ambulation. After 9 days, the patient’s functional status was improved and was medically optimized. The patient received a left ventricular assist device as destination therapy. He was discharged home, resumed his normal activities and has been doing well for more than 27 months.

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