Simple technique of distal leg perfusion during heart transplant in patients with preoperative veno-arterial extracorporeal membrane oxygenation support. (April 2023)

• Record Type: Journal Article
• Authors: Ohira, Suguru; Pan, Stephen; Levine, Avi; Aggarwal-Gupta, Chhaya; Lanier, Gregg M; Gass, Alan L; Spielvogel, David; Kai, Masashi
• Is Part Of: Perfusion. Volume 38:Number 3(2023)
• Page Start: 473
• Page End: 476
• Publication Date: 2023-04
• Subjects: Femoral artery -- veno-arterial extracorporeal membrane oxygenation -- limb ischemia -- heart transplant -- leg perfusion; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/02676591211064721
• Languages: English
• ISSNs: 0267-6591

Abstract

Direct heart transplant from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is challenging. Continuation of postoperative VA-ECMO support may be required in the setting of primary graft dysfunction or severe vasoplegia. We describe a simple technique to perfuse the ipsilateral leg of an arterial ECMO cannula during heart transplant while the ECMO circuit is turned off but maintaining the arterial cannula and distal perfusion catheter in place. This technique minimizes the number of intraoperative procedures with a minimal risk of leg ischemia, and provides a smooth transition to postoperative VA-ECMO support if necessary.