Surgical repair of an aortic coarctation in a patient after treatment with extracorporeal membrane oxygenation.
Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for neonates who have severe respiratory failure that does not respond to maximal conventional therapy. A consequence of venoarterial ECMO is the sacrifice of the right common carotid artery. Evaluation of the impact of a single carotid artery in babies treated with ECMO concerns mostly long-term neurodevelopmental outcome. The authors encountered a peculiar problem caused by a single carotid artery in a post-ECMO patient during the surgical correction of aortic coarctation with hypoplastic distal aortic arch. For patients with a confirmed cardiac malformation that necessitates future surgical repair and for whom ECMO support is required, reconstruction of the right common carotid artery should be considered. Veno-venous ECMO is an alternative solution if this approach is not contraindicated because of the patient's clinical condition. Patients with congenital diaphragmatic hernia have a higher incidence of cardiac malformations; therefore, careful cardiological attention is required. Anomalies masked by pulmonary hypertension also must be considered.
Schöller
M
M
ECMO group, University Hospital, Nijmegen, The Netherlands.
vd Staak
F
F
Liem
K D
KD
Draaisma
J M
JM
Lacquet
L K
LK
Festen
C
C
D001017:Aortic Coarctation / Q000209:etiology / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D006548:Hernia, Diaphragmatic / Q000628:therapy*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male