Cardiac Catheterization via Direct Access of Venoarterial Extracorporeal Membrane Oxygenation Circuit

Obtaining arterial access for cardiac catheterization can be both challenging and morbid in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). While catheterization performed by obtaining endovascular access through the ECMO circuit itself has been described, all previous cases utilized a Y-connector and accessory tubing limb. We report a novel technique whereby arterial access was obtained directly via standard VA-ECMO arterial return tubing, through which coronary angiography was successfully performed in a 67-year-old woman. This technique may reduce the incidence of morbidity attendant with obtaining vascular accesses in patients on ECMO without requiring insertion of new circuit components.