One-year experience of bedside percutaneous VA-ECMO decannulation in a high-ECMO-volume center in Hong Kong.

Perfusion
Shek-Yin AuKit-Hung Anne Leung

Abstract

When veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support can be terminated, open repair of arteriotomy wounds in operating theaters is the standard of practice. Comparable outcomes by percutaneous decannulation using different closure devices have been reported. However, transport of the critically- ill, man-power and timeslots of operating theaters could be saved if decannulation was performed at bedside. Bedside percutaneous arteriotomy wound closure became our default method of decannulation since November 2018. We reviewed our 1-year data to evaluate if such practice could be safely adopted in a local high-ECMO-volume center. Between November 2018 and October 2019, 25 patients had their VA-ECMO terminated at the bedside. Twenty-one patients (84%) had successful decannulation. For those who failed, emergency open repair resulted in no additional complications. Two ProGlide devices were used in 15 (71.4%) patients and three were used in 6 (28.6%) patients. The procedure time was 27 (15-45) min. The median blood loss was 300 mL (250-400). Minor complications were found in 4 (19.1%) patients, including two arterial clot formation, one pseudoaneurysm and one wound infection. There were no other major complication...Continue Reading

References

Nov 28, 2012·Nature Reviews. Cardiology·Robert A ByrneAdnan Kastrati
Mar 14, 2013·Cardiovascular and Interventional Radiology·Abdel Aziz A JaffanTimothy P Murphy
Jun 15, 2013·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Daniel P GrieseJörg Babin-Ebell
Jun 4, 2019·The Canadian Journal of Cardiology·José M Montero-CabezasA de Weger
Feb 23, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Quentin PellencYves Castier

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Methods Mentioned

BETA
dissection

Software Mentioned

SPSS
ProGlide

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