ArticleBMJ case reports2022
Bicaval dual lumen cannula placement using transthoracic echocardiography in COVID-19 scenario: pearls and pitfalls.
Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 9 citations in OpenAlex.
- V-A ECMO treatment via drainage from the right internal jugular vein to the inferior vena cava ostium for high-risk pulmonary embolism complicated by cardiac arrest with filter placement: case report.International journal of emergency medicine · 2026Article
- Inserting a venoarterial extracorporeal membrane oxygenation drainage cannula into the inferior vena cava through the internal jugular vein in a patient with an inferior vena cava filter.International journal of emergency medicine · 2025Article
- Emergency veno-arterial extracorporeal membrane oxygenation cannulation through the femoral vein with a pre-positioned inferior vena cava filter: A case report.World journal of clinical cases · 2025Article
- Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation.International journal of emergency medicine · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A woman in her 50s who had been diagnosed with COVID-19 developed deep vein thrombosis in the left femoral vein extending into inferior vena cava (IVC). An IVC filter was placed to prevent fatal pulmonary embolism. Her respiratory failure subsequently deteriorated despite optimal mechanical ventilation and required venovenous extracorporeal membrane oxygenation (VV-ECMO) as a rescue therapy. Femoro-jugular VV-ECMO configuration was not suitable due to the IVC filter, hence a single-site venous cannulation using bicaval dual lumen (AvalonElite) cannula was selected. Placement of the Avalon cannula conventionally requires guidance by fluoroscopy or transoesophageal echocardiography, which were not feasible in COVID-19 patients. Hence, transthoracic echocardiography guidance was chosen. Guidewire looping into the right ventricle might lead to cannula malposition and imminent right ventricular rupture, but these could be detected by 'bending' sign. Transthoracic echocardiography could be a feasible guidance method for Avalon cannulation, nonetheless a thorough protocol should be followed to avoid cannula malposition during the procedure.
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