Complete percutaneous decannulation from femoral venoarterial extracorporeal membrane oxygenation

Authors

Aakash Shah, University of Maryland School of Medicine
Mehrdad Ghoreishi, University of Maryland School of Medicine
Bradley S. Taylor, University of Maryland School of Medicine
Shahab Toursavadkohi, University of Maryland School of Medicine
David J. Kaczorowski, University of Maryland School of Medicine
Chetan Pasrija, University of Maryland School of Medicine
Douglas Tran, University of Maryland School of Medicine
Mohamed Abdullah, University of Maryland School of Medicine
Ronson J. Madathil, University of Maryland School of Medicine
Kristopher B. Deatrick, University of Maryland School of Medicine
Michael A. Mazzeffi, University of Maryland R Adams Cowley Shock Trauma Center
Ashley Menne, University of Maryland R Adams Cowley Shock Trauma Center
Jay Menaker, University of Maryland R Adams Cowley Shock Trauma Center
James S. Gammie, University of Maryland School of Medicine
Bartley P. Griffith, University of Maryland School of Medicine

Document Type

Journal Article

Publication Date

4-1-2021

Journal

JTCVS Techniques

Volume

6

DOI

10.1016/j.xjtc.2020.11.005

Keywords

extracorporeal membrane oxygenation; mechanical circulatory support; percutaneous vascular closure

Abstract

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.

APA Citation

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