Shah Aakash, Ghoreishi Mehrdad, Taylor Bradley S, Toursavadkohi Shahab, Kaczorowski David J
Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.
Division of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Md.
JTCVS Tech. 2020 Nov 21;6:75-81. doi: 10.1016/j.xjtc.2020.11.005. eCollection 2021 Apr.
To evaluate the clinical outcomes and perioperative complications associated with complete percutaneous decannulation of femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) with the MANTA closure device.
This is a retrospective analysis of a single surgeon consecutive series of 14 patients at a single center who underwent decannulation from VA-ECMO, 10 of whom underwent a percutaneous method of femoral cannula removal.
After a mean duration of VA-ECMO support of 7.4 ± 3.8 days, all 10 patients, with arterial cannulas ranging in size from 17 to 21 Fr, underwent percutaneous decannulation with the MANTA closure device, with immediate hemostasis. One patient had acute lower limb ischemia that was recognized intraoperatively and successfully treated with suction embolectomy. Two patients had a pseudoaneurysm at the distal perfusion catheter site recognized on perioperative imaging studies, one resolving with observation and the other necessitating thrombin injection. One patient had a hematoma that resolved with observation.
Percutaneous decannulation from VA-ECMO using the MANTA large-bore vascular closure device is feasible and results in immediate hemostasis with excellent angiographic results.
评估使用MANTA闭合装置完全经皮拔除股动静脉体外膜肺氧合（VA-ECMO）插管的临床结局和围手术期并发症。
这是一项对单一中心一位外科医生连续收治的14例接受VA-ECMO插管拔除患者的回顾性分析，其中10例采用经皮方法拔除股动静脉插管。
在平均7.4±3.8天的VA-ECMO支持时间后，所有10例患者（动脉插管尺寸为17至21F）均使用MANTA闭合装置进行了经皮插管拔除，止血迅速。1例患者术中出现急性下肢缺血，经抽吸血栓切除术成功治疗。2例患者在围手术期影像学检查中发现远端灌注导管部位出现假性动脉瘤，1例经观察后消退，另1例需要注射凝血酶。1例患者出现血肿，经观察后消退。
使用MANTA大口径血管闭合装置经皮拔除VA-ECMO插管是可行的，可实现立即止血，血管造影结果良好。
