Korean J Crit Care Med.  2015 Nov;30(4):295-298. 10.4266/kjccm.2015.30.4.295.

Extracorporeal Membrane Oxygenation for 67 Days as a Bridge to Heart Transplantation in a Postcardiotomy Patient with Failing Heart and Mediastinitis

• Chang HW
• Cho YH
• Cho S
• Sung K
• Park PW

• KMID: 2156183
• DOI: http://doi.org/10.4266/kjccm.2015.30.4.295

Abstract

We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.

Keyword

cardiomyopathy; extracorporeal membrane oxygenation; heart; mediastinitis; shock; transplantation

MeSH Terms

Cardiomyopathies
Extracorporeal Membrane Oxygenation*
Extremities
Heart Transplantation*
Heart*
Humans
Mediastinitis*
Myocardial Infarction
Perfusion
Shock
Transplantation
Wound Infection

Figure

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  Fig. 1. Left ventricular vent catheter inserted via right anterior thoracotomy (arrow).

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  Fig. 2. Chest radiographs that were obtained before (A), immediately after (B), and two days after (C) vent cannula insertion. Pulmonary edema had resolved in (C).

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  Fig. 3. Summary of key events during ECMO support. ECMO: extracorporeal membrane oxygenator; CAG: coronary angiography; CPR: cardiopulmonary resuscitation; CABG: coronary artery bypass grafting; TPL: transplantation; CC: circuit (oxygenator & pump) change; HC: head (centrifugal pump) change; LV: left ventricle.

Reference

References

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