Using suture-mediated closure device for extracorporeal membrane oxygenation decannulation: A single-center experience of post-closing technique

Abstract

Background:

Extracorporeal membrane oxygenation (ECMO) is a critical treatment for severe cardiopulmonary failure. However, traditional ECMO decannulation methods, such as manual compression and surgical repair, are associated with significant complications. This study evaluates suture-mediated closure devices, specifically Perclose ProGlide, as a potentially favorable decannulation strategy.

Methods:

A retrospective review was conducted on 31 patients who underwent arterial decannulation with the post-closing technique using Perclose ProGlide devices between September 2023 and June 2024. Patients were selected using various inclusion criteria for the approach. Decannulation was performed at the bedside by well-trained vascular surgeons. Outcome parameters like the hemostatic result, wound complication, and limb ischemia were analyzed.

Results:

The study included 31 patients with a need for decannulation of ECMO arterial cannula, with a mean age of 51.1 years. Thirty patients (96.8%) achieved successful primary hemostasis. The patient who failed primary hemostasis developed acute ischemia due to septic shock caused by the use of inotropic agents. No significant complications were observed in the rest of the patients.

Conclusion:

The post-closing technique using suture-mediated closure devices demonstrated high success and low complication rates, making it a safer and more effective alternative to traditional ECMO decannulation methods. This study showed outstanding results compared to previously published articles. This technique can provide various significant advantages under certain clinical situations.