TITLE:
Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome
AUTHORS:
Daniel Manzur-Sandoval, Gian Manuel Jiménez-Rodríguez, Edgar García-Cruz, Ramón Espinosa-Soto, Erika Yamali Ramirez-Marcano, Yessenia Máyory Téllez-López, José Luis Elizalde-Silva, Gustavo Rojas-Velasco
KEYWORDS:
Eisenmenger Syndrome, Venopulmonary Artery ECMO, Refractory Hypoxemia, Right Ventricular Dysfunction
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.14 No.1,
January
24,
2024
ABSTRACT: Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become
a standard of care for patients with circulatory (venoarterial) and/or
respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are
an increasingly recognized and growing population and include various
groups, such as undiagnosed cases in
childhood and palliated and/or corrected cases, which require subsequent care because of residual
lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions.
In addition, these patients are prone to
developing pathologies that are typical of adulthood with a generally increased
risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart
disease, which makes them candidates
for ECMO. These patients represent an additional challenge in this
therapy because malformations and the presence of a shunt can generally affect
the usual cannulation methods and hemodynamic and oximetry monitoring. Thus,
the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method,
venopulmonary artery ECMO, which
provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in
patients with congenital heart diseases.