title: Surgical repair of an aortic coarctation in a patient after treatment with extracorporeal membrane oxygenation.
abstract: 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.
authors.affiliation: ECMO group, University Hospital, Nijmegen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Schöller
authors.forename: F
authors.initials: F
authors.lastname: vd Staak
authors.forename: K D
authors.initials: KD
authors.lastname: Liem
authors.forename: J M
authors.initials: JM
authors.lastname: Draaisma
authors.forename: L K
authors.initials: LK
authors.lastname: Lacquet
authors.forename: C
authors.initials: C
authors.lastname: Festen
mesh_terms: 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