Heart, lung & circulation
-
Heart, lung & circulation · Dec 2010
Review Case ReportsVeno-arterial extracorporeal membrane oxygenation for high-risk cardiac catheterisation procedures.
Extracorporeal membrane oxygenation (ECMO) provides circulatory or respiratory support, or both, to patients with severe but potentially reversible cardiac or respiratory failure refractory to standard therapy. The use of ECMO in the paediatric cardiac surgical population is established. ⋯ We herein review the indications, technical procedure, complications and outcomes of extracorporeal membrane oxygenation as pertinent to cardiac disease in general, and specifically, to catheter-based interventions. We describe two cases of high-risk cardiac catheterisation laboratory procedures performed with veno-arterial ECMO support in adult patients who were deemed to be at unacceptably high risk for conventional open-heart surgery and cardiopulmonary bypass.
-
Heart, lung & circulation · Dec 2010
Axillary artery cannulation for aortic and complex cardiac surgery.
Cannulation of the axillary artery for cardiopulmonary bypass (CPB) avoids manipulation of an atherosclerotic, aneurysmal, or dissected ascending aorta. Advantages include: low risk of atheroemboli, low risk of malperfusion in dissections, and facilitates selective antegrade cerebral perfusion (SACP) during hypothermic circulatory arrest (HCA). ⋯ Axillary artery cannulation is a safe and reliable technique for arterial inflow minimising the risks of atheroembolisation and malperfusion reflected by low morbidity and mortality, and should be the standard in aortic and complex cardiac surgery.