The use of percutaneous ECMO support as a 'bridge to bridge' in heart failure patients: a case report

Perfusion
David FitzgeraldLori Edwards

Abstract

A 65-year-old male with a known history of ischemic cardiomyopathy was admitted to the intensive care unit in cardiogenic shock. Cardiac catheterization revealed bi-ventricular hypokinesis, with an estimated ejection fraction of 15%. Despite moderate inotropic support, the patient's liver enzymes, international normalization ratio (INR), and creatinine became grossly elevated, indicating multi-organ injury from hypoperfusion. Due to the patient's state of shock and probable bleeding complications, a full sternotomy and emergent biventricular assist device insertion was deemed very high risk. In order to achieve hemodynamic stability, a decision was made for extracorporeal membrane oxygenation (ECMO) support. ECMO support was quickly initiated by percutaneous cannulation of the femoral vein and artery. The ECMO circuit was comprised of a Centrimag blood pump and Quadrox-D Safeline-coated membrane oxygenator. With successful perfusion and organ resuscitation, abnormal liver function tests, INR, and creatinine all returned to normal in less than one week. With normal organ function, especially the liver, the patient successfully underwent an implantable left ventricular assist device, HeartMate II LVAD, without requiring mechanica...Continue Reading

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Citations

Apr 24, 2012·Journal of Critical Care·Kiran ShekarJason A Roberts
Mar 21, 2015·Methodist DeBakey Cardiovascular Journal·Walid K Abu SalehBrian A Bruckner
Jul 6, 2014·Critical Care Clinics·Jeffrey J Teuteberg, Josephine C Chou
Sep 26, 2015·Seminars in Cardiothoracic and Vascular Anesthesia·Lindsay RaleighCharles Hill
Jun 28, 2021·The Journal of Thoracic and Cardiovascular Surgery·Andrew M Vekstein, Oliver K Jawitz

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