Atrial Septostomy for Left Atrial Decompression During Extracorporeal Membrane Oxygenation by Inoue Balloon Catheter

Circulation Journal : Official Journal of the Japanese Circulation Society
Yen-Nien LinPing-Han Lo

Abstract

Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients.Methods and Results:We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014. Mean left ventricular ejection fraction was 15%. The cause of cardiogenic shock included 7 cases of ischemic heart disease, 1 of dilated cardiomyopathy, 5 of myocarditis, and 2 of fatal ventricular arrhythmia.The procedures were performed 4.3 days after ECMO. Inoue balloon size was 24-27 mm. LA septostomy were successfully created in 14 patients. Procedure time on average was 36.8 min (range, 15-85 min). There were no procedure-related complications.Radiography on the next day showed rapid resolution of pulmonary edema. Trans-septal LA decompre...Continue Reading

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Citations

Aug 1, 2019·Korean Circulation Journal·Min Suk ChoiYang Hyun Cho
May 19, 2020·European Cardiology·Leonardo GuimaraesJosep Rodés-Cabau
Nov 30, 2020·Interactive Cardiovascular and Thoracic Surgery·Ali İhsan HasdeAhmet Ruchan Akar
Sep 19, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Suneel Ramesh Desai, Nian Chih Hwang
Jan 2, 2019·The Journal of Thoracic and Cardiovascular Surgery·Jason J Han, Pavan Atluri
Jul 13, 2021·Circulation. Heart Failure·Darshan H BrahmbhattFilio Billia

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