Transthoracic Echocardiography-guided ECMO Cannulation in the Emergency Department: A Case Report

Transesophageal echocardiography and fluoroscopy are often favored over TTE for ECMO cannulation due to greater resolution of the former modalities. Transesophageal echocardiography is invasive, less accessible, and requires greater expertise. Fluoroscopy requires patients to be moved to a catheterization suite and comes with a risk of extra radiation and contrast-induced nephropathy. While the concept of TTE-guided ECMO cannulation is not especially novel, few case reports exist on its emergent deployment in the ED. Here, we discuss a unique case in which TTE proved effective for timely ECMO deployment for a critically ill ED patient.