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Case Reports
. 2022 Sep;25(3):279-282.
doi: 10.1007/s10047-021-01306-z. Epub 2022 Jan 18.

Fracture of dual lumen cannula leading to cerebrovascular accident in a patient supported with ECMO

Salem T Argaw  1 , Paul J Devlin  1 , James A Clark  1 , Rafael Garza-Castillon  1 , Chitaru Kurihara  2 , Ankit Bharat  3   4
Affiliations
Case Reports

Fracture of dual lumen cannula leading to cerebrovascular accident in a patient supported with ECMO

Salem T Argaw et al. J Artif Organs. 2022 Sep.

Abstract

Extended duration extracorporeal membrane oxygenation (ECMO), using dual-lumen cannulas, is being used with increased frequency to support patients, including those with COVID-19; both as a bridge to transplant and lung recovery. During such an extended duration of support, there are several factors that might lead to the attrition of the physical structure of the ECMO cannulas, predisposing them to the risk of fracture. Although rare, fracture of the ECMO cannula can be a potentially lethal event. Here, we present a case where fracture of a dual lumen cannula during veno-venous (VV) ECMO support resulted in a cerebrovascular accident. We discuss the potential contributing factors and suggest steps to mitigate the risks for such a complication.

Keywords: Cannula; ECMO; Respiratory failure.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Cannula site fracture. A Fracture of Crescent™ VV-ECMO B PROTEK Duo™ cannula withc a site of fracture marked with blue arrow (C and D) Close up of fracture site with slight flex on the distal cannula
Fig. 2
Fig. 2
Sites of circuit fracture. A PROTEK Duo™. Flexion at the bifurcation (I) or bending of the cannula in the right ventricle (II) can lead to circuit fracture. B Crescent™. When placed in a subclavian approach, the cannula can bend under the clavicle at the skin entry point (III) increasing the risk of fracture. Bending of the cannula at the wire reinforcement (refer to Fig. 1) of Crescent™ cannula can also lead to fracture
See this image and copyright information in PMC

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