Complete percutaneous decannulation from femoral venoarterial extracorporeal membrane oxygenation
extracorporeal membrane oxygenation; mechanical circulatory support; percutaneous vascular closure
Objectives: To evaluate the clinical outcomes and perioperative complications associated with complete percutaneous decannulation of femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) with the MANTA closure device. Methods: This is a retrospective analysis of a single surgeon consecutive series of 14 patients at a single center who underwent decannulation from VA-ECMO, 10 of whom underwent a percutaneous method of femoral cannula removal. Results: After a mean duration of VA-ECMO support of 7.4 ± 3.8 days, all 10 patients, with arterial cannulas ranging in size from 17 to 21 Fr, underwent percutaneous decannulation with the MANTA closure device, with immediate hemostasis. One patient had acute lower limb ischemia that was recognized intraoperatively and successfully treated with suction embolectomy. Two patients had a pseudoaneurysm at the distal perfusion catheter site recognized on perioperative imaging studies, one resolving with observation and the other necessitating thrombin injection. One patient had a hematoma that resolved with observation. Conclusions: Percutaneous decannulation from VA-ECMO using the MANTA large-bore vascular closure device is feasible and results in immediate hemostasis with excellent angiographic results.
Shah, A., Ghoreishi, M., Taylor, B., Toursavadkohi, S., Kaczorowski, D., Pasrija, C., Tran, D., Abdullah, M., Madathil, R., Deatrick, K., Mazzeffi, M., Menne, A., Menaker, J., Gammie, J., & Griffith, B. (2021). Complete percutaneous decannulation from femoral venoarterial extracorporeal membrane oxygenation. JTCVS Techniques, 6 (). http://dx.doi.org/10.1016/j.xjtc.2020.11.005