Adult extracorporal membrane oxygenation utilization in the ICU has rapidly increased. Newer technology and cannulation strategies and the complex hemodynamics make imaging interpretation challenging. There is also a high rate of complications. This review details the common indications, cannulation strategies, relevant hemodynamics and complications which impact imaging interpretation. Recommendations for modifying computed tomography protocols and techniques to obtain diagnostic images and some of the imaging pitfalls are also discussed.
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http://dx.doi.org/10.1067/j.cpradiol.2020.10.018 | DOI Listing |
Medicina (Kaunas)
January 2025
Cardiovascular Institute "Dedinje", 111040 Belgrade, Serbia.
Coronary artery fistulas (CAFs) are rare congenital anomalies, presenting in 0.05-0.9% of cases, characterized by an aberrant connection between a coronary artery and a cardiac chamber or great vessel.
View Article and Find Full Text PDFBMJ Open
January 2025
School of Nursing & Midwifery, University of Galway, Galway, Ireland.
Introduction: The peripheral vascular catheter (PVC) is the most common intravenous medical device used in hospitals, given it is crucial for the delivery of intravenous therapies. Despite its widespread use, PVC complications such as occlusion, infiltration, extravasation, phlebitis, thrombophlebitis, catheter-related thrombosis and catheter-related bloodstream infection significantly affect patient safety, leading to increased morbidity and healthcare costs. One approach to maintain PVC patency and therefore device longevity is to flush the PVC.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
January 2025
Department of Cardiothoracic Surgery, Heart-Thorax Center, Klinikum Fulda, University Medicine Marburg, Campus Fulda, 36043 Fulda, Germany.
Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.
Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine.
J Cardiovasc Dev Dis
January 2025
Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Cardiac computed tomography (CT) has become an essential tool in the pre-procedural planning and optimization of coronary interventions. Its non-invasive nature allows for the detailed visualization of coronary anatomy, including plaque burden, vessel morphology, and the presence of stenosis, aiding in precise decision making for revascularization strategies. Clinicians can assess not only the extent of coronary artery disease but also the functional significance of lesions using techniques like fractional flow reserve (FFR-CT).
View Article and Find Full Text PDFPediatr Crit Care Med
January 2025
Department of Pediatrics, Division of Pediatric Critical Care, Vanderbilt University Medical Center, Nashville, TN.
Objectives: Small studies of extracorporeal membrane oxygenation (ECMO) support for children with refractory septic shock (RSS) suggest that high-flow (≥ 150 mL/kg/min) venoarterial ECMO and a central cannulation strategy may be associated with lower odds of mortality. We therefore aimed to examine a large, international dataset of venoarterial ECMO patients for pediatric sepsis to identify outcomes associated with flow and cannulation site.
Design: Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) database from January 1, 2000, to December 31, 2021.
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