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Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2012

Open Access 01-12-2012 | Case report

Right ventricular rupture and tamponade caused by malposition of the Avalon cannula for venovenous extracorporeal membrane oxygenation

Authors: Hitoshi Hirose, Kentaro Yamane, Gregary Marhefka, Nicholas Cavarocchi

Published in: Journal of Cardiothoracic Surgery | Issue 1/2012

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Abstract

Placement of the Avalon Elite bicaval dual lumen cannula for venovenous extracorporeal membrane oxygenation (VV-ECMO) via the internal jugular vein requires precise positioning of the cannula tip in the inferior vena cava with echocardiography or fluoroscopy guidance. Correct guidewire placement is clearly the key first step in assuring proper advancement of the cannula. We report a case of unexpected wire migration into the right ventricle at the time of final cannula advancement, resulting in right ventricular rupture and tamponade. Transesophageal echocardiography is an important monitoring modality for appropriate placement of the VV-ECMO guidewire and Avalon cannula, and in particular, for early identification of potential complications.
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Literature
1.
Bermudez CA, Rocha RV, Sappington PL, Toyoda Y, Murray HN, Boujoukos AJ: Initial experience with single cannulation for venovenous extracorporeal oxygenation in adults. Ann Thorac Surg. 2010, 90: 991-995. 10.1016/j.athoracsur.2010.06.017.CrossRefPubMed
2.
Javidfar J, Brodie D, Wang D: Use of bicavaldual-lumencatheter for adult venovenous extracorporeal membrane oxygenation. Ann Thorac Surg. 2011, 91: 1763-1768. 10.1016/j.athoracsur.2011.03.002.CrossRefPubMed
Metadata
Title
Right ventricular rupture and tamponade caused by malposition of the Avalon cannula for venovenous extracorporeal membrane oxygenation
Authors
Hitoshi Hirose
Kentaro Yamane
Gregary Marhefka
Nicholas Cavarocchi
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2012
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-7-36

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