Ohira Suguru, Pan Stephen, Levine Avi, Aggarwal-Gupta Chhaya, Lanier Gregg M, Gass Alan L, Spielvogel David, Kai Masashi
Department of Surgery, Division of Cardiothoracic Surgery, New York Medical College, 8138Westchester Medical Center, Valhalla, NY, USA.
Department of Cardiology, New York Medical College, 8138Westchester Medical Center, Valhalla, NY, USA.
Perfusion. 2023 Apr;38(3):473-476. doi: 10.1177/02676591211064721. Epub 2021 Dec 27.
Direct heart transplant from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is challenging. Continuation of postoperative VA-ECMO support may be required in the setting of primary graft dysfunction or severe vasoplegia. We describe a simple technique to perfuse the ipsilateral leg of an arterial ECMO cannula during heart transplant while the ECMO circuit is turned off but maintaining the arterial cannula and distal perfusion catheter in place. This technique minimizes the number of intraoperative procedures with a minimal risk of leg ischemia, and provides a smooth transition to postoperative VA-ECMO support if necessary.
在静脉-动脉体外膜肺氧合（VA-ECMO）支持下进行直接心脏移植具有挑战性。在原发性移植物功能障碍或严重血管麻痹的情况下，可能需要在术后继续进行VA-ECMO支持。我们描述了一种简单的技术，即在心脏移植期间，当ECMO回路关闭时，灌注动脉ECMO插管同侧的腿部，同时将动脉插管和远端灌注导管保持在原位。该技术可将术中操作次数减至最少，腿部缺血风险降至最低，并在必要时为术后VA-ECMO支持提供平稳过渡。
