Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome  

作　　者：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 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(Cardiovascular Critical Care Unit, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico;Adult Congenital Heart Disease Unit, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico;Cardiology Department, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico)

机构地区：[1]Cardiovascular Critical Care Unit, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico [2]Adult Congenital Heart Disease Unit, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico [3]Cardiology Department, Ignacio Chávez National Institute of Cardiology, Mexico City, Mexico

出　　处：《World Journal of Cardiovascular Surgery》2024年第1期7-19,共13页心血管外科国际期刊（英文）

摘　　要：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.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.

关 键 词：Eisenmenger Syndrome Venopulmonary Artery ECMO Refractory Hypoxemia Right Ventricular Dysfunction 

分 类 号：R65[医药卫生—外科学]