title: Left ventricle unloading by percutaneous pigtail during extracorporeal membrane oxygenation.
abstract: Arterial-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.
authors.affiliation: Department of Cardiac Surgery, Istituto Clinico Humanitas IRCCS, Via A. Manzoni 56, 20089 Rozzano (MI), Italy. alessandro.barbone@humanitas.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Barbone
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Malvindi
authors.forename: Pietro
authors.initials: P
authors.lastname: Ferrara
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarelli
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D057785:Catheters; D003664:Decompression / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left