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经皮 VA-ECMO 置管至拔管:血管闭合装置在儿科中的新应用。

Percutaneous VA-ECMO from Cannulation to Decannulation: Novel Use of a Vascular Closure Device in Pediatrics.

机构信息

The Heart Center, Children's Hospital Colorado, University of Colorado, 13123 E 16th Ave, B100, Aurora, CO, 80045, USA.

出版信息

Pediatr Cardiol. 2023 Oct;44(7):1623-1628. doi: 10.1007/s00246-023-03222-w. Epub 2023 Jul 7.

Abstract

VA-ECMO can be lifesaving in cardiogenic shock in children. While surgical vascular repair is the current standard of care for decannulation, it comes with notable risks. We present a series of eight patients who underwent decannulation with a collagen plug-based vascular closure device (MANTA) for the common femoral artery. Seven of the patients were successfully decannulated without access site-related vascular complications. One required conversion to surgical cut-down with arterial repair due to device failure. This series demonstrates the successful use of the MANTA device in percutaneous VA-ECMO decannulation in the pediatric population, while highlighting potential technical challenges for success.

摘要

VA-ECMO 可在小儿心源性休克中救命。虽然外科血管修复是目前脱机的标准治疗方法,但它存在显著风险。我们介绍了一系列 8 例患者,他们使用基于胶原塞的血管闭合装置(MANTA)进行股总动脉脱机。7 例患者成功脱机,无与入路相关的血管并发症。1 例因器械故障需要转为外科切开并进行动脉修复。本系列研究表明,MANTA 器械在小儿经皮 VA-ECMO 脱机中成功应用,但也突出了成功应用所面临的潜在技术挑战。

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