VA ECMO with pulmonary artery ventilation
A veno-arterial extracorporeal membrane oxygenation system includes a dual lumen drainage cannula configured for withdrawing blood from a patient's vasculature in a manner that provides a perfusion of oxygenated blood with reduced carbon dioxide content while unloading the left ventricle, with two points of access to the patient's vasculature. The dual lumen drainage cannula has a first drainage tube and a second drainage tube co-axially aligned with the first drainage tube. The first and second drainage tubes are fluidly coupled to a connector. A blood pump having a pump inlet is configured for fluidly connecting with the connector, while an oxygenator having an oxygenator inlet is configured for fluidly connecting with a pump outlet. An infusion cannula is configured for fluidly connecting with an oxygenator outlet for infusing oxygenated blood into a patient's bloodstream.
1. A veno-arterial extracorporeal membrane oxygenation (VA ECMO) system comprising:
a dual lumen drainage cannula comprising:
a first drainage tube having a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end;
a second drainage tube coaxially aligned with the first drainage tube and having a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end; and
a connector configured for fluidly connecting with the first drainage tube and the second drainage tube;
a blood pump having a pump inlet and a pump outlet, the pump inlet configured for fluidly connecting to the connector;
an oxygenator having an oxygenator inlet and an oxygenator outlet, the oxygenator inlet configured for fluidly connecting with the pump outlet; and
an infusion cannula configured for fluidly connecting with the oxygenator outlet,
wherein the first drainage tube and the second drainage tube are fixedly connected to each other along a length of a tapering section of the second drainage tube, and
wherein the first drainage tube is configured for drainage from a right atrium and the second drainage tube is configured for drainage from a pulmonary artery.
2. The VA ECMO system of claim 1 , wherein the first drainage tube has at least one first drainage aperture provided at the distal end.
3. The VA ECMO system of claim 2 , wherein the second drainage tube has at least one second drainage aperture provided at the distal end.
4. The VA ECMO system of claim 2 , wherein the at least one first drainage aperture extends through the sidewall of the first drainage tube.
5. The VA ECMO system of claim 3 , wherein the at least one second drainage aperture extends through the sidewall of the second drainage tube.
6. The VA ECMO system of claim 2 , wherein the at least one first drainage aperture extends through the sidewall of the first drainage tube in a direction perpendicular to a longitudinal axis of the first drainage tube.
7. The VA ECMO system of claim 3 , wherein the at least one second drainage aperture extends through the sidewall of the second drainage tube in a direction perpendicular to a longitudinal axis of the second drainage tube.
8. The VA ECMO system of claim 2 , wherein the at least one first drainage aperture extends through the sidewall of the first drainage tube at an acute or obtuse angle with respect to a longitudinal axis of the first drainage tube.
9. The VA ECMO system of claim 3 , wherein the at least one second drainage aperture extends through the sidewall of the second drainage tube at an acute or obtuse angle with respect to a longitudinal axis of the second drainage tube.
10. The VA ECMO system of claim 2 , wherein a plurality of first drainage apertures extends in a circular pattern around the first drainage tube.
11. The VA ECMO system of claim 3 , wherein a plurality of second drainage apertures extends in a circular pattern around the second drainage tube.
12. The VA ECMO system of claim 3 , wherein the at least one first drainage aperture is separated from the at least one second drainage aperture by a predetermined distance along a longitudinal axis of the first drainage tube.
13. The VA ECMO system of claim 12 , wherein the predetermined distance is selected based on at least one of patient age, patient size, and a desired flow rate.
14. The VA ECMO system of claim 1 , wherein the dual lumen cannula is adapted for maneuvering through the patient's vasculature such that the distal end of the first drainage tube is substantially within the patient's right atrium and such that the distal end of the second drainage tube is substantially within the patient's pulmonary artery.
15. The VA ECMO system of claim 1 , wherein the pump is a centrifugal pump, an axial pump, or a roller pump.
16. The VA ECMO system of claim 1 , further comprising a controller for controlling the operation of the pump.
17. A dual lumen drainage cannula configured for use in a veno-arterial extracorporeal membrane oxygenation (VA ECMO) system, the dual drainage cannula comprising:
a first drainage tube configured for insertion into a right atrium of a patient, the first drainage tube having a body with a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end with at least one first drainage aperture provided at the distal end, the at least one first drainage aperture extending through the sidewall of the first drainage tube;
a second drainage tube configured for insertion into a pulmonary artery of a patient, the second drainage tube coaxially aligned with the first drainage tube and having a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end with at least one second drainage aperture provided at the distal end, the at least one second drainage aperture extending through the sidewall of the second drainage tube; and
a connector configured for fluidly connecting with the first drainage tube and the second drainage tube,
wherein the first drainage tube and the second drainage tube are fixedly connected to each other along a length of a tapering section of the second drainage tube, and
wherein the first drainage tube is configured for drainage from a right atrium and the second drainage tube is configured for drainage from a pulmonary artery.
18. The VA ECMO system of claim 17 , wherein the at least one first drainage aperture is separated from the at least one second drainage aperture by a predetermined distance along a longitudinal axis of the first drainage tube.
19. The VA ECMO system of claim 18 , wherein the predetermined distance is selected based on at least one of patient age, patient size, and a desired flow rate.
20. A method of providing veno-arterial extracorporeal membrane oxygenation (VA ECMO) of a heart, the method comprising:
providing a dual lumen drainage cannula comprising:
a first drainage tube having a body with a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end with at least one first drainage aperture provided at the distal end, the at least one first drainage aperture extending through the sidewall of the first drainage tube;
a second drainage tube coaxially aligned with the first drainage tube and having a proximal end, a distal end, and a sidewall extending between the proximal end and the distal end with at least one second drainage aperture provided at the distal end, the at least one second drainage aperture extending through the sidewall of the second drainage tube; and
a connector configured for fluidly connecting with the first drainage tube and the second drainage tube,
wherein the first drainage tube and the second drainage tube are fixedly connected to each other along a length of a tapering section of the second drainage tube;
inserting the dual lumen drainage cannula into a first site in a patient's vasculature;
maneuvering the dual lumen drainage cannula through the patient's vasculature such that the first distal end of the first infusion tube is at least within proximity of the patient's right atrium and such that the second distal end of the second drainage tube is at least within proximity of the patient's pulmonary artery;
withdrawing blood through the first and second drainage tubes using a blood pump;
pumping withdrawn blood through an oxygenator to reduce carbon dioxide content of the blood; and
delivering oxygenated blood with reduced carbon dioxide content to a second site in the patient's vasculature.