Percutaneous VA-ECMO from Cannulation to Decannulation: Novel Use of a Vascular Closure Device in Pediatrics

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Medical Device Technology

Background:

• Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a critical intervention for pediatric cardiogenic shock.
• Decannulation from VA-ECMO typically requires surgical vascular repair, which carries inherent risks.
• Minimally invasive techniques for vascular closure are sought to improve patient outcomes.

Purpose of the Study:

• To evaluate the safety and efficacy of the MANTA vascular closure device for percutaneous VA-ECMO decannulation in pediatric patients.
• To compare outcomes of MANTA device closure with traditional surgical repair for VA-ECMO access sites.

Main Methods:

• A retrospective case series of eight pediatric patients undergoing VA-ECMO decannulation.
• Utilized the MANTA collagen plug-based vascular closure device for common femoral artery access site closure.
• Documented procedural success, decannulation time, and access site-related complications.

Main Results:

• Seven out of eight patients (87.5%) were successfully decannulated without access site-related vascular complications using the MANTA device.
• One patient experienced device failure requiring conversion to surgical cut-down and arterial repair.
• No major bleeding events or pseudoaneurysms were reported in the successfully treated patients.

Conclusions:

• The MANTA vascular closure device represents a viable option for percutaneous VA-ECMO decannulation in the pediatric population.
• This technique may reduce the need for surgical intervention and associated complications.
• Careful patient selection and operator experience are crucial for optimizing success rates and mitigating potential technical challenges.