Simple left ventricular apical cannulation for temporary mechanical circulatory support

J Card Surg. 2022 Jun;37(6):1787-1792. doi: 10.1111/jocs.16414. Epub 2022 Mar 24.

Abstract

Surgical management of cardiogenic shock, utilizing mechanical circulatory support, can provide a bridge to recovery, bridge to decision making and/or bridge to transplantation. Despite extracorporeal membrane oxygenation (ECMO) being a reliable, temporary form of support, intracardiac thrombosis is a devastating complication of veno-arterial ECMO. The use of a temporary left ventricular assist device (LVAD), although not immune to thrombosis, helps reduce intracardiac thrombosis, maintaining flow through the heart but importantly allowing for concurrent venting and drainage of the left ventricle. We demonstrate a technique for LV apical cannulation, as a part of a temporary LVAD circuit, aiming to prevent thrombotic complications secondary to cannula angulation.

Keywords: perfusion; transplant.

MeSH terms

  • Catheterization
  • Heart Ventricles / surgery
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy
  • Thrombosis* / etiology
  • Thrombosis* / prevention & control