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

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초록

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.

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.

참고문헌 (5)

  1. Francis GS, "ACCF", AHA, HFSA, pp.ISHLT 2010 clinical competence statement on management of patients with advanced heart failure and cardiac transplant: a report of the ACCF, AHA[DOI]
  2. Barth E, "Extracorporeal life support as a bridge to high-urgency heart transplantation", Clin Transplant, 26, pp.484~488 (2012)
  3. Cho YH, "Extracorporeal life support as a bridge to heart transplantation: importance of organ failure in recipient selection", ASAIO J, 61, pp.139~143 (2015)
  4. Aubron C, "Factors associated with outcomes of patients on extracorporeal membrane oxygenation support:a 5-year cohort study", Crit Care, 17, pp.R73~ (2013)
  5. Guttendorf J, "Discharge outcome in adults treated with extracorporeal membrane oxygenation", Am J Crit Care, 23, pp.365~377 (2014)

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