So today was supposed to be a rest day for Eddie before clamping off ECMO again tomorrow. However, after this morning's x-ray, it became clear that his venous cannula was dangerously high and would need to be addressed one way or the other. Since re-establishing him on ECMO after repositioning the cannula carries significant risks, we began to discuss taking him off ECMO entirely rather than waiting for tomorrow.
So about an hour ago we turned off the machine and Eddie has been doing all of his own work. In spite of a period of junctional rhythm (not good) during the trial off, he has recovered and is in good sinus rhythm with good heart rate and blood pressure. We are going to watch him for the hour or so to see how well he does before the surgeons come in to remove the cannula.
Most likely, his vein is going to be in pretty bad shape since the cannula has been in place for a week and he has been a very "active" patient. The surgeons will try to repair the vein, but it's possible they won't be able to suture it and will need to creatively close the vein.
Once again, we are on a roller coaster ride and every day brings new surprises. If all goes well, this could be a great step for Eddie . . . his body and heart will certainly let us know what he needs. If he struggles, there are a variety of options available to us from implanting the VAD (Berlin Heart) to recannulizing via his femoral artery, but we'll cross those bridges when we get to them.