Direct cannulation of the infrahepatic vena cava for emergent cardiopulmonary bypass support.
Tex Heart Inst J
; 36(4): 316-20, 2009.
Article
en En
| MEDLINE
| ID: mdl-19693306
ABSTRACT
Cannulation for cardiopulmonary bypass, although seemingly routine, can pose technical challenges. In patients undergoing repeat sternotomy, for example, peripherally established cardiopulmonary bypass may be necessary to ensure safe entry into the chest; however, establishing bypass in this way can sometimes be complicated by patients' body habitus. We describe a technique for direct cannulation of the infrahepatic abdominal vena cava that was required for emergent cardiopulmonary bypass. The patient was a 62-year-old woman who had presented with severely symptomatic left main coronary stenosis 3 months after elective aortic valve replacement. She had gone into cardiogenic shock as general anesthesia was being induced for repeat sternotomy and myocardial revascularization. Emergent establishment of femorofemoral cardiopulmonary bypass was precluded by difficulties in advancing the femoral venous cannula beyond the pelvic brim. Hence, an emergent celiotomy was performed, and the abdominal vena cava was directly cannulated to establish venous drainage for cardiopulmonary bypass. The rest of the operation was uneventful. Our technique for direct cannulation of the infrahepatic abdominal vena cava may be used in exceptional circumstances. Necessary precautions and potential pitfalls are also presented.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Choque Cardiogénico
/
Vena Cava Inferior
/
Cateterismo Venoso Central
/
Puente Cardiopulmonar
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Puente de Arteria Coronaria
/
Estenosis Coronaria
Tipo de estudio:
Etiology_studies
Límite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Tex Heart Inst J
Año:
2009
Tipo del documento:
Article
País de afiliación:
Estados Unidos