Thrombosis of the Right Internal Jugular Vein is Not a Contraindication to Ambulatory Veno-Venous Extracorporeal Membrane Oxygenation with a Bicaval Dual-Lumen, Single Cannula System

  • Anthony Kronfli Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • Chetan Pasrija Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • Aakash Shah Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • Mehrdad Ghoreishi Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • Jose P Garcia Department of Cardiothoracic Surgery, Hahnemann University Hospital, Philadelphia, Pennsylvania
  • Si M Pham Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
  • Pablo G Sanchez Department of Cardiothoracic Surgery, University of Washington Seattle, Seattle, Washington
  • Zachary N Kon Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland

Abstract

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement.
Case report: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS). Ambulatory VV-ECMO support was initiated, and during surgical cannula placement an occlusive thrombus was noted in the right IJ vein. A tract was dilated and the cannula was placed without any thromboembolic complications.
Conclusion: This case demonstrates that cannulation for ambulatory VV-ECMO in the setting of an occlusive IJ thrombus can be safe and feasible.

Author Biography

Anthony Kronfli, Department of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland
Anthony Kronfli is a medical student at the University Of Marytland School of Medicine.

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Published
2016-12-14
Section
Articles