title: Ease of conversion from venovenous extracorporeal membrane oxygenation to cardiopulmonary bypass and venoarterial extracorporeal membrane oxygenation with a bicaval dual lumen catheter.
abstract: Extracorporeal circulatory support revolutionized the field of cardiothoracic surgery, initially in the form of cardiopulmonary bypass (CPB) and then in its modified form, extracorporeal membrane oxygenation (ECMO). Although initial cannulation techniques involved open intrathoracic approaches, the increased prevalence of reoperative sternotomies and the emergence of minimally invasive surgery encouraged the development of peripheral cannulation methods and configurations. The Avalon Elite Bicaval Dual Lumen catheter (Avalon Laboratories, LLC, CA) can be placed in the right internal jugular vein to provide venovenous (VV) ECMO. However, some patients on VV ECMO then develop compromised cardiac performance. We describe two ways in which the Avalon Elite was used, first for complete venous drainage through a single peripheral site for CPB and in the other to convert a patient on VV ECMO to axillary artery venoarterial (VA) ECMO.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Columbia-Presbyterian Hospital, New York, New York 10032, USA. mb781@columbia.edu
authors.forename: Matthew
authors.initials: M
authors.lastname: Bacchetta
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Javidfar
authors.forename: Joshua
authors.initials: J
authors.lastname: Sonett
authors.forename: Hyonah
authors.initials: H
authors.lastname: Kim
authors.forename: Joseph
authors.initials: J
authors.lastname: Zwischenberger
authors.forename: Dongfang
authors.initials: D
authors.lastname: Wang
mesh_terms: D002315:Cardiopulmonary Bypass; D002404:Catheterization; D057785:Catheters; D003550:Cystic Fibrosis / Q000628:therapy; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000737:chemistry*; D012131:Respiratory Insufficiency
chemical_list: D010100:Oxygen