[How to Place Percutaneous Cardiopulmonary Support(PCPS)]

Area of Science:

• Cardiovascular Surgery
• Medical Device Technology

Background:

• Percutaneous cardiopulmonary support (PCPS) and extracorporeal membrane oxygenation (ECMO) require vascular cannulation.
• Percutaneous cannulation is standard, but surgical cut-down may be needed for access.
• Vascular access strategies vary based on clinical scenarios and patient anatomy.

Purpose of the Study:

• To review cannulation techniques for PCPS and ECMO.
• To highlight alternative cannulation methods when percutaneous access is challenging.
• To emphasize the importance of surgical proficiency in cannulation procedures.

Main Methods:

• Review of standard and alternative cannulation techniques for PCPS and ECMO.
• Discussion of vessel selection, including femoral and neck vessels.
• Description of Seldinger technique versus direct cut-down cannulation.

Main Results:

• Percutaneous cannulation is preferred, but cut-down exposure allows direct or Seldinger technique placement.
• Femoral vessels are common, but neck vessels are used for veno-venous ECMO.
• Central cannulation of the aorta and right atrium is an option for patients on cardiopulmonary bypass.

Conclusions:

• Cannulation for PCPS and ECMO involves diverse techniques and vessel choices.
• Thoracic surgeons must master these procedures and understand potential complications like bleeding and malperfusion.
• Up-to-date knowledge and surgical skill are crucial for successful patient outcomes.