Optimized safety and function of the bicaval dual-lumen cannula by refined positioning and bedside management.

摘要

We read with interest the report by Reis Miranda et al. [1] on a complicated right ventricular dislodgement of the Avalon ELITE? cannula several days after fluoroscopy-guided introduction.We share concerns on the pivotal role of a stable cannula position in the inferior caval vein (ICV), and adapted introduction procedure and bedside management accordingly: combined guidance by transthoracic and transesophageal echocardiogra-phy allows clear identification of important anatomical landmarks as Eustachian ridge and ICV (Fig. 1, top) [2].