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Case Reports
. 2023 Apr;38(3):654-656.
doi: 10.1177/02676591211066805. Epub 2022 Jan 20.

Tracheal stenting on venovenous ECMO with a dual lumen right atrium-to-pulmonary artery cannula in a COVID-19 patient with an inferior vena cava filter

Marco Giani  1   2 , Andrea Pisa  1 , Eliseo Passera  3 , Leonello Avalli  2 , Roberto Rona  2 , Giuseppe Foti  1   2
Affiliations
Case Reports

Tracheal stenting on venovenous ECMO with a dual lumen right atrium-to-pulmonary artery cannula in a COVID-19 patient with an inferior vena cava filter

Marco Giani et al. Perfusion. 2023 Apr.

Abstract

A 47-year-old man, with no medical history, was diagnosed with severe COVID-19 ARDS and pulmonary embolism. Venovenous extracorporeal membrane oxygenation (ECMO) was required for impossibility to deliver protective ventilation. The patient was weaned from ECMO after clinical improvement. An inferior vena cava filter was then positioned to prevent embolization from a persistent left femoral deep venous thrombosis. Two days after the ECMO removal, a large lesion of the tracheal posterior wall was diagnosed. Tracheal stenting was deemed necessary. ECMO support was then re-established, to safely perform the bronchoscopic procedure. Due to the presence of the inferior vena cava filter, the patient was cannulated via the right internal jugular vein with a double lumen ProtekDuo cannula. The patient was then weaned from ECMO support and invasive ventilation. The tracheal stent was removed after 40 days, showing a full recovery of the tracheal lesion. The patient was discharged home in good condition.

Keywords: ARDS; COVID-19; ECMO; acute respiratory distress syndrome; tracheal lesion; venovenous extracorporeal membrane oxygenation.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A picture of the tracheal lesion taken during fiberoptic bronchoscopy. A wide lesion of the pars membranacea is shown in the lower third of the picture.
Figure 2.
Figure 2.
Chest X-ray showing the tracheal stent and the ProtekDuo cannula.
See this image and copyright information in PMC

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