Percutaneous Pulmonary Artery Venting via Jugular Vein While on Peripheral Extracorporeal Life Support
| Autor: | Antonio Loforte, Cinzia Marrozzini, Erika Dal Checco, Davide Pacini, Giuseppe Marinelli, Sofia Martin Suarez, Gregorio Gliozzi, Valeria Lo Coco, Massimo Baiocchi, Mariafrancesca Fiorentino, Mauro Biffi |
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| Přispěvatelé: | Loforte A, Baiocchi M, Dal Checco E, Gliozzi G, Fiorentino M, Lo Coco V, Martin Suarez S, Marrozzini C, Biffi M, Marinelli G, Pacini D. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Shock Cardiogenic Biomedical Engineering Biophysics Heart failure Bioengineering Pulmonary Artery 030204 cardiovascular system & hematology Extracorporeal Biomaterials 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Mechanical circulatory support Internal medicine medicine.artery medicine Extracorporeal membrane oxygenation Humans Myocardial infarction Aged Heart transplantation business.industry Cardiogenic shock General Medicine Middle Aged medicine.disease surgical procedures operative 030228 respiratory system Pulmonary artery Cardiology Female Jugular Veins Left ventricular venting business |
| Zdroj: | ASAIO Journal. 66:e50-e54 |
| ISSN: | 1058-2916 |
| DOI: | 10.1097/mat.0000000000000991 |
| Popis: | Peripheral extracorporeal membrane oxygenation (ECMO) setting remains a valid option to treat cardiogenic shock (CS). We investigated a percutaneous approach to unload the left ventricle (LV) while on veno-arterial (v-a) peripheral ECMO support. Between 2017 and 2018, eight patients (three females, mean age: 49.6 years old, and five males, mean age: 58 years old, respectively) suffered refractory CS due to acute myocardial infarction (n = 4), acute myocarditis (n = 2), acute decompensation on chronic heart failure (n = 1), and primary graft failure after heart transplantation (Htx) (n = 1), respectively. After a multidisciplinary CS team discussion, it was decided to proceed with peripheral v-a ECMO placement and percutaneous LV venting via right internal jugular vein access to drain the pulmonary artery (PA), in the hybrid operating room. In a single postcardiotomy case, the PA trunk was vented centrally. Mean ECMO support time was 8.5 days. Seven (87.5%) patients were successfully weaned from ECMO and one (12.5%) successfully bridged to Htx. All patients were successfully discharged after treatment except for a single case who died due to sepsis. In case of not recommended usage of LV apical venting, the adoption of v-a peripheral ECMO support associated with percutaneous PA drainage enables the rapid onset of extracorporeal life support with an effective biventricular unloading. |
| Databáze: | OpenAIRE |
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