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Interact Cardiovasc Thorac Surg · Sep 2011
Left ventricle unloading by percutaneous pigtail during extracorporeal membrane oxygenation.
- Alessandro Barbone, Pietro Giorgio Malvindi, Pietro Ferrara, and Giuseppe Tarelli.
- Department of Cardiac Surgery, Istituto Clinico Humanitas IRCCS, Via A. Manzoni 56, 20089 Rozzano (MI), Italy. alessandro.barbone@humanitas.it
- Interact Cardiovasc Thorac Surg. 2011 Sep 1;13(3):293-5.
AbstractArterial-venous extracorporeal membrane oxygenation (ECMO) is more and more used as first line mechanical support in acute cardiopulmonary failure. Important pitfall of this technique is the inappropriate unloading of left ventricle (LV) in case of myocardial insufficiency, leading to pulmonary stasis and inadequate myocardial recovery. We report our experience of left side unloading by a 7-F pigtail, introduced in the LV through the aortic valve, connected to the venous drainage. Echographic guidance is sufficient to pigtail positioning and follow-up monitoring avoiding catheterization laboratory transport. With this approach we were able to support three different patients, resolving LV distension and preventing lung congestion, without major complication.
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