Czerwonko Matias E, Fraga Maria V, Goldberg David J, Hedrick Holly L, Laje Pablo
Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
J Card Surg. 2015 Apr;30(4):370-2. doi: 10.1111/jocs.12507. Epub 2014 Dec 29.
Proper functioning of the Avalon Elite® bicaval dual lumen ECMO cannula (Maquet Cardiovascular, Wayne, NJ, USA) requires precise placement of the distal draining port within the lumen of the inferior vena cava (IVC). In order to advance the cannula to the correct position, a 0.038" guidewire is placed into the IVC under echocardiographic or fluoroscopic guidance. We report a case of perforation of the intrapericardiac section of the IVC by the guidewire in a neonate, not detected at the time of placement, resulting in cardiac tamponade and death. We recommend routine echocardiographic surveillance after placement of Avalon Elite® cannulas to rule out hemopericardium.
Avalon Elite®双腔静脉体外膜肺氧合插管（美国新泽西州韦恩市马奎特心血管公司生产）的正常功能需要将远端引流端口精确放置在下腔静脉（IVC）腔内。为了将插管推进到正确位置，需在超声心动图或荧光透视引导下将一根0.038英寸的导丝置入IVC。我们报告了一例新生儿病例，导丝在放置时未被发现，导致IVC心包内段穿孔，进而引发心脏压塞并导致死亡。我们建议在放置Avalon Elite®插管后进行常规超声心动图监测，以排除心包积血。
