Abstract
Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO’s major limitations: in patients who have smallcaliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 537-539 |
| Number of pages | 3 |
| Journal | Texas Heart Institute Journal |
| Volume | 42 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2015 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
Cite this
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Modified T-graft for extracorporeal membrane oxygenation : In a patient with small-caliber femoral arteries. / Calderon, Daniel; El-Banayosy, Aly; Koerner, Michael M.; Reed, Amy B.; Aziz, Faisal.
In: Texas Heart Institute Journal, Vol. 42, No. 6, 01.12.2015, p. 537-539.Research output: Contribution to journal › Article
TY - JOUR
T1 - Modified T-graft for extracorporeal membrane oxygenation
T2 - In a patient with small-caliber femoral arteries
AU - Calderon, Daniel
AU - El-Banayosy, Aly
AU - Koerner, Michael M.
AU - Reed, Amy B.
AU - Aziz, Faisal
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO’s major limitations: in patients who have smallcaliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation.
AB - Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO’s major limitations: in patients who have smallcaliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation.
UR - http://www.scopus.com/inward/record.url?scp=84949215635&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84949215635&partnerID=8YFLogxK
U2 - 10.14503/THIJ-14-4728
DO - 10.14503/THIJ-14-4728
M3 - Article
C2 - 26664305
AN - SCOPUS:84949215635
VL - 42
SP - 537
EP - 539
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
SN - 0730-2347
IS - 6
ER -