Veno-venous extra-corporeal membrane oxygenation-assisted right tracheal-sleeve pneumonectomy

Antonio Mazzella, Luca Bertolaccini, Francesco Petrella, Lorenzo Spaggiari
2021 Interactive Cardiovascular and Thoracic Surgery  
Tracheal sleeve pneumonectomy for lung cancer is an old technique, and it is reserved for exceptional cases with tracheal carina involvement. Intra-operative airways management of this operation is incredibly complex, involving thoracic surgeons, anaesthesiologists and pulmonologists. We report a case of a 38-year-old male with no clinical history, referred to our department for an adenoid-cystic carcinoma involving distal trachea, carina and main right bronchus. Tracheal sleeve pneumonectomy
more » ... eve pneumonectomy was performed using extra-corporeal membrane oxygenation (ECMO). A veno-venous ECMO circuit was established through a heparin-coated percutaneous cannula in the right femoral vein and a heparin-coated percutaneous cannula in the internal right jugular vein by ultrasound assistance. No major complications occurred, and the patient was discharged after 30-day bronchoscopic control, showing the absence of fistula and negativity of the methylene blue test. ECMO-assisted surgery ensures adequate respiratory support, haemodynamic stability, lower risk of bleeding complications with a clean operating field and better brain and myocardial oxygenation.
doi:10.1093/icvts/ivab124 pmid:33993258 fatcat:hpvypxymkvby3iqcnvdvjtd6r4