Utility of three-dimensional transesophageal echocardiography to guide
transseptal positioning of a single multistage venous cannula to provide
both venous drainage and indirect left ventricular venting in
veno-arterial extracorporeal membrane oxygenation.
A patient with heart failure due to dilated ischemic cardiomyopathy
presented in cardiogenic shock for institution of veno-arterial
extracorporeal membrane oxygenation as a bridge to cardiac
transplantation. To provide adequate venous drainage and simultaneous
decompression of the left atrium (indirect left ventricular venting) a
single venous cannula was placed across the interatrial septum so the
distal orifice and side ports were located within the left atrium and
the proximal set of side ports at the cavoatrial junction.
Three-dimensional transesophageal echocardiography demonstrated utility
in guiding cannula placement and appropriate positioning within the left