METHOD FOR HAEMODYNAMIC LEFT VENTRICULAR UNLOAD IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION

摘要

FIELD: medicine.;SUBSTANCE: after the beginning of the extracorporeal membrane oxygenation (ECMO), a left atrium is punctured through an interatrial septum using a femoral approach. The formed opening is dilated to 5.7-6.3 mm, and a vent cannula is delivered in the ascending direction into the left atrium through a femoral vein, a right atrium and the formed opening in the interatrial septum. The cannula is arranged so that a cannula end is found within the left atrium; and a second end of the drain cannula is connected to a venous line of an ECMO loop through a Y connector. In each specific case, the interatrial septum is punctured by means of an atriotome within an oval fossa. In each specific case, an opening in the interatrial septum is formed by a puncture of the femoral vein. A guide with its distal end reduced to the level of a superior vena cava is delivered through a puncture needle. Thereafter, a transseptal needle is delivered to the level of a superior vena cava entry inside a catheter inserted into the right femoral vein. Thereafter, a needle tip is placed into the oval fossa; a short piercing motion of the whole system is performed to pierce the interatrial septum, and the left atrium is penetrated. That is followed by sequential dilation of the interatrial septum opening, and the drain cannula is brought. In each specific case, the drain cannula 17F is brought into the interatrial septum.;EFFECT: method enables preventing and treating complications caused by blood congestion in the left compartments of the heart, including pulmonary oedema in the ECMO.;4 cl, 1 tbl, 1 ex