JACC. Case reports · 2025
Axillary VA-ECMO Implantation Under Regional Block Anesthesia.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lefebvre Thomas, Bayart Guillaume, Briffa Florent, Landemaine Thomas, Peschanski Julia, Esmard Paul-Emmanuel, Beal Romain, Mahjoub Yazine, Dupont Hervé, Abou-Arab Osama
Аннотация
BACKGROUND: Axillary venoarterial extracorporeal membrane oxygenation (VA-ECMO) implantation for refractory cardiogenic shock traditionally requires general anesthesia, risking hemodynamic compromise in critically ill patients.
FIRST-IN-HUMAN/EARLY REPORTS SUMMARY: We report the first-in-human axillary VA-ECMO cannulation via Dacron tube graft performed under locoregional anesthesia with sedation in a 58-year-old man with SCAI stage D cardiogenic shock. The procedure was successfully completed, with excellent patient tolerance, hemodynamic stability, and preserved neurologic monitoring throughout. The patient achieved successful ECMO weaning after 7 days, with preserved limb function and no cannulation-related complications through 30-day follow-up.
DISCUSSION: This novel approach avoided general anesthesia-related hemodynamic compromise while enabling continuous neurologic assessment. Subsequent patient mortality at 75 days resulted from unrelated device infections and was not attributable to the innovative cannulation technique.
NOVELTY: This is the first reported axillary ECMO cannulation under regional anesthesia, eliminating general anesthesia risks in critically ill cardiac patients.
TAKE-HOME MESSAGE: Regional anesthesia enables safe axillary ECMO cannulation in high-risk patients while preserving hemodynamic stability and neurologic monitoring capabilities.
FIRST-IN-HUMAN/EARLY REPORTS SUMMARY: We report the first-in-human axillary VA-ECMO cannulation via Dacron tube graft performed under locoregional anesthesia with sedation in a 58-year-old man with SCAI stage D cardiogenic shock. The procedure was successfully completed, with excellent patient tolerance, hemodynamic stability, and preserved neurologic monitoring throughout. The patient achieved successful ECMO weaning after 7 days, with preserved limb function and no cannulation-related complications through 30-day follow-up.
DISCUSSION: This novel approach avoided general anesthesia-related hemodynamic compromise while enabling continuous neurologic assessment. Subsequent patient mortality at 75 days resulted from unrelated device infections and was not attributable to the innovative cannulation technique.
NOVELTY: This is the first reported axillary ECMO cannulation under regional anesthesia, eliminating general anesthesia risks in critically ill cardiac patients.
TAKE-HOME MESSAGE: Regional anesthesia enables safe axillary ECMO cannulation in high-risk patients while preserving hemodynamic stability and neurologic monitoring capabilities.