Modified AngioVac System use With Extracorporeal Membrane Oxygenation in a Child With Fontan Thrombosis

Abstract

Supplemental Digital Content is available in the text.

Percutaneous transeptal mitral valve endocarditis debulking with AngioVac aspiration system

“…Angiovac percutaneous vacuum‐assisted aspiration system has been successfully utilized to aspirate right sided (atrial, tricuspid valve or vena cava) vegetations, pulmonic valve vegetations, right atrial masses, vena cava thrombus, thrombus/vegetation of cardiac implantable electronic devices, and for aspiration of thoracic aortic mass 4–8 . Other case report and series of patients describing novel and unique use of AngioVac aspiration system in various patient subset ie; pregnant, congenital heart disease, inferior vena cava filter thrombosis and cancer related thrombosis are further listed in Table 1 9,10 . While there are no official guidelines for intended use, it is generally reserved for patients who are inoperable or at high/prohibitive surgical risk.…”

“…[4][5][6][7][8] Other case report and series of patients describing novel and unique use of AngioVac aspiration system in various patient subset ie; pregnant, congenital heart disease, inferior vena cava filter thrombosis and cancer related thrombosis are further listed in Table 1. 9,10 While there are no official guidelines for intended use, it is generally reserved for patients who are inoperable or at high/prohibitive surgical risk. The AngioVac system includes the AngioVac cannula, AngioVac circuit and is intended for use with other manufacturer's off-the shelf pump, filter, and reinfusion cannula requiring extracorporeal circulatory support for up to 6 h. There are two cannulas available with a 20°or 180°angled tip.…”

Working Around: The Use of AngioVac and Micra Transcatheter Leadless Pacemaker Implantation in a Critically Ill Patient Receiving Extracorporeal Membrane Oxygenation

“…Modifications to the AngioVac device to include an oxygenator in the extracorporeal circuit have been described in the literature [9][10][11], although this represents a novel use of the AngioVac system to temporarily replace the venous component of a preexisting ECMO circuit intraoperatively. A similar use to the one described here has been achieved previously, although this represents the first reported case in which this method was used to treat thrombosis in an adult, and the second overall in which the patient survived to discharge from the hospital [12,13].…”

The AngioVac System in Childhood and Adolescence: A New Venovenous Extracorporeal Membrane Oxygenation-Like Configuration

“…To date, four cases have been reported in the pediatric age. However, in the congenital case by Priest et al ., 6 the Fontan anatomy did not permit the successful use of the AngioVac cannula (due to the presence of intrapulmonary stents and small pulmonary artery diameters) and a custom-made standard 17Fr arterial cannula was used to aspirate the pulmonary clots, indeed. Nowadays, the new generations of AngioVac cannula have further expanded the versatility of this device: 18Fr versus 22Fr of caliber and 20° vs. 85° vs. 180° angled tip.…”

“…[1][2][3][4] However, it is still not regularly used in children, with only two reported cases in the pediatric population. 5,6 Nevertheless, in only one case, AngioVac was performed successfully. 5 This article aims to report our experience with AngioVac in two young patients, in whom we adopted a novel venous-venous extracorporeal membrane oxygenation (ECMO)-like configuration of the extracorporeal circuit to sustain the impaired respiratory function during the procedure.…”