Percutaneous decannulation of peripheral veno-arterial extracorporeal membrane oxygenation using the Manta closure device

To the Editor, In cardiac surgery intensive care unit (CICU) the use of short-term mechanical circulatory support is increasingly common, such as venoarterial extracorporeal membrane oxygenation (VA-ECMO). The implantation of this device is almost always peripheral and involves the cannulation of a large-bore femoral arterial access. For this reason, vascular complications are a very common finding in patients on peripheral VA-ECMO1 with decannulation being one of the most critical moments. Currently, there are 2 types of vascular closure devices widely used in the cath lab: suture-based devices, such as the ProGlide (Abbott Vascular, United States), and collagen plug devices, such as the Angio-Seal (Terumo Corporation, Japan) and the Manta (Teleflex, United States). The latter has been specifically designed for the closure of large-bore arteriotomies using an intra-arterial anchoring system and an extra-arterial collagen plug, and is marketed in 2 different sizes: 14-Fr (for 10-14-Fr introducer sheaths and holes with an external diameter of up to 18-Fr) and 18-Fr (for 15-18-Fr introducer sheaths and holes with an external diameter of up to 25-Fr). Evidence in the field of structural heart procedures with the Manta device is very extensive2 and there is increasing experience in closing the arterial access of mechanical circulatory support systems,3,4...

Abstract licence: CC BY-NC-ND

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