Left ventricle unloading by percutaneous pigtail during extracorporeal membrane oxygenation |
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Authors: | Barbone Alessandro Malvindi Pietro Giorgio Ferrara Pietro Tarelli Giuseppe |
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Affiliation: | Department of Cardiac Surgery, Istituto Clinico Humanitas IRCCS, Via A. Manzoni 56, 20089 Rozzano (MI), Italy. alessandro.barbone@humanitas.it |
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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. |
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