Right ventricular loop indicating malposition of J-wire introducer for double lumen bicaval Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) cannula

Authors

Konstantin Yastrebov, University of New South Wales
Con Manganas, University of WollongongFollow
Tejo Kapalli, St George Hospital
Sheen Peeceeyen, St George Hospital

RIS ID

87216

Publication Details

Yastrebov, K., Manganas, C., Kapalli, T. & Peeceeyen, S. (2014). Right ventricular loop indicating malposition of J-wire introducer for double lumen bicaval Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) cannula. Heart Lung and Circulation, 23 (1), e4-e7.

Abstract

The key to safe placement of a bicaval double lumen cannula for Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) is to visualise correct guide wire placement in the inferior vena cava (IVC), thus aiding subsequent correct advancement of the cannula. Transoesophageal (TOE) and transthoracic (TTE) echocardiography, as well as fluoroscopy, have been described as aiding imaging techniques. We report a case of guide wire malposition into the right ventricle, despite echocardiographic confirmation of guide wire position deep into the IVC. This malposition, if undetected, may have resulted in potential life threatening complications.