Key result
Avalon cannula guidewire malposition during VV-ECMO placement results in RV rupture and acute cardiac tamponade.
Why the study?
Precise positioning of the Avalon Elite bicaval dual lumen cannula for VV-ECMO is critical to avoid complications such as right ventricular rupture and tamponade.
Case Report (n=1)
No
Transesophageal echocardiography is an important monitoring modality for appropriate placement of the VV-ECMO guidewire and Avalon cannula to prevent and identify complications like right ventricular rupture.
Answers are grounded in this paper and cite their sources.
Highlights VV-ECMO guidewire malposition risk; supports TEE monitoring yet leaves optimal protocols open.
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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Hirose et al. (2012) conducted a case report in Severe viral pneumonia and ARDS (n=1). Avalon Elite bicaval dual lumen cannula for VV-ECMO was evaluated.
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