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Percutaneous decannulation reduces procedure length and rates of groin wound infection in patients on venoarterial extracorporeal membrane oxygenation

Sophia Roberts, Erin M. Schumer, Mary Sullivan, John C. Grotberg, Bianca Jenkins, I. Fischer, M. Damiano, Matthew R. Schill, Muhammad Masood, Kunal Kotkar, Amit Pawale

2024JTCVS Open11 citationsDOIOpen Access PDF

Abstract

Objective: Open decannulation from femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) carries high risk of morbidity, including groin wound infection. This study evaluated the impact of percutaneous decannulation on rates of groin wound infection in patients decannulated from femoral VA-ECMO. Methods: Between January 1, 2022, and April 30, 2023, 47 consecutive patients received percutaneous femoral VA-ECMO and survived to decannulation. A percutaneous suture-mediated closure device was used for decannulation in patients with relatively smaller arterial cannulas. Patients with larger arterial cannulas or unsuccessful percutaneous closures underwent surgical cutdown and repair of the femoral artery. The primary outcome was arterial site wound infection following decannulation. Results: = .03) when compared with the surgical cutdown group. Three patients (14.3%) in the percutaneous group experienced vascular complications, including pseudoaneurysm at the distal perfusion catheter site and nonocclusive thrombus of the common femoral artery. Conclusions: Percutaneous decannulation may reduce decannulation procedure length and rate of groin wound infection in patients who survive to decannulation from VA-ECMO.

Topics & Concepts

MedicinePercutaneousGroinSurgeryFemoral arteryPseudoaneurysmExtracorporeal membrane oxygenationCatheterComplicationInfectious Aortic and Vascular ConditionsVascular Procedures and ComplicationsMechanical Circulatory Support Devices