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How To Place a Patient on Veno-Venous ECMO

This video shows how to place a patient on veno-venous ECMO. The author uses an Avalon catheter inserted into the right jugular vein. The Avalon catheter has an inflow lumen that takes blood from the IVC and SVC, and an outflow lumen that delivers blood towards the tricuspid valve. In this video, the author demonstrates the insertion of the Avalon catheter and the commencement of ECMO support.

This procedure was performed at the Freeman Hospital in Newcastle, UK. The procedure was performed by Mr. Stephen Clark, a Consultant Cardiothoracic and Transplant surgeon.


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  1. The dilators provided with the Avalon Elite are excellent and enable single dilatation without the need for sequential dilatation described in this video. Over dilatation i.e. 30 Fr dilator for the 27 Fr cannula can greatly aid cannula placement without any increase in the risk of bleeding at the site of insertion
    The cannula shown in this video appears to be high without the tip of the cannula lying within the IVC as it is designed to be. A cannula positioned in this way often provides sufficient support but may increase the risk of right atrial perforation and subsequent tamponade.

  2. The dilators provided with the Avalon Elite are excellent and enable single dilatation without the need for sequential dilatation described in this video. Over dilatation i.e. 30 Fr dilator for the 27 Fr cannula can greatly aid cannula placement without any increase in the risk of bleeding at the site of insertion
    The cannula shown in this video appears to be high without the tip of the cannula lying within the IVC as it is designed to be. A cannula positioned in this way often provides sufficient support but may increase the risk of right atrial perforation and subsequent tamponade.

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