Right Atrial Perforation Leading to Cardiac Tamponade Following Veno-Venous Extracorporeal Membrane Oxygenation Cannulation

Jasmine Sandhu; Ryan K Dean; David Landsberg

doi:10.7759/cureus.13157

Right Atrial Perforation Leading to Cardiac Tamponade Following Veno-Venous Extracorporeal Membrane Oxygenation Cannulation

Cureus. 2021 Feb 5;13(2):e13157. doi: 10.7759/cureus.13157.

Authors

Jasmine Sandhu¹, Ryan K Dean², David Landsberg^{3

2}

Affiliations

¹ Internal Medicine, State University of New York Upstate Medical University, Syracuse, USA.
² Internal Medicine/Critical Care, State University of New York Upstate Medical University, Syracuse, USA.
³ Internal Medicine/Critical Care, Crouse Hospital, Syracuse, USA.

Abstract

Extracorporeal membrane oxygenation (ECMO), as a supportive modality for cardiopulmonary failure, is increasing in its use due to improved advances in technology and experience lending to availability and ease of implementation. Complications with ECMO are quite common, and with increasing use, an increase in complications are a natural result. These complications can be from the underlying disease process or from the ECMO process itself, including cannula insertion. One such complication includes perforation of surrounding structures at site of insertion. We will present a case of right atrial perforation after single lumen cannula insertion, which led to development of cardiac tamponade and subsequently cardiac arrest. In addition to cannula design, lack of wire rigidity can play a role in wire migration and injury to surrounding structures. We emphasize the importance of ultrasound guidance and surveillance with echocardiogram or fluoroscopy during ECMO cannulation, regardless of cannula type, to prevent fatal complications.

Keywords: cannulation; ecmo; ecmo complication; tamponade; vv ecmo.

Publication types

Case Reports