Emergency repair of proximal hard-tube connector crack during veno-arterial extracorporeal membrane oxygenation support: a case report

Background: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is critical for patients with severe cardiac or respiratory failure. Circuit damage, particularly at the proximal hard tube connector, can lead to complications such as blood leakage and hemodynamic instability. This case report examines the repair of a crack in the proximal hard tube connector during V-A ECMO treatment. Case presentation: A 70-year-old female receiving peripheral V-A ECMO support via femoral cannulation for acute heart failure suffered a crack in the proximal hard tube connector, causing arterial blood leakage. The team performed an emergency repair using bone wax while maintaining low-flow ECMO operation. The repair was successful, and V-A ECMO support was continued without interruption, with stable hemodynamics. Conclusion: Bone wax proved effective for repairing the V-A ECMO circuit crack in this case. The low-flow operation ensured uninterrupted V-A ECMO support and maintained hemodynamic stability, offering an alternative to full circuit replacement in similar cases.