title: Internal Jugular Vein Avulsion Complicating Dual-Lumen VV-ECMO Cannulation: An Unreported Complication of Avalon Cannulas.
abstract: The Avalon Elite dual lumen cannula (Avalon Laboratories, Rancho Dominguez, CA) was developed as a means of single-site cannulation for veno-venous extracorporeal membrane oxygenation in patients with severe refractory respiratory failure. This cannulation strategy has several advantages over conventional strategies, however, is not without complication. We describe a case of right internal jugular vein "on a stick" (avulsion) after cannulation with the Avalon Elite cannula, and corroborate the critical importance of imaging guidance when using this system.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University Hospital, London Health Sciences Center, London, Ontario, Canada.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Tarola
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University Hospital, London Health Sciences Center, London, Ontario, Canada. Electronic address: Dave.Nagpal@lhsc.on.ca.
authors.forename: A Dave
authors.initials: AD
authors.lastname: Nagpal
mesh_terms: D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000293:injuries; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000150:complications; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control