title: Successful rescue of sustained ventricular tachycardia/ventricular fibrillation after coronary artery bypass grafting by extracorporeal membrane oxygenation.
abstract: Extracorporeal membrane oxygenation (ECMO) can be set up quickly at the bedside and provides reliable temporary mechanical circulatory support for severe heart failure. We report the case of a 56-year-old female with circulatory collapse due to sustained ventricular tachycardia and ventricular fibrillation (VT/Vf) after coronary artery bypass grafting (CABG) who was successfully resuscitated using ECMO. The sustained VT/Vf might have been secondary to myocardial stunning, ischemia, infarction, or reperfusion. There were 40 cardioversions within the first 5 postoperative days. The patient improved after 8 days of ECMO in addition to use of an intraaortic balloon pump and administration of inotropic agents for profound heart failure. Left ventricular ejection fraction improved from 28% preoperatively to 54.5% on the 20th postoperative day. Cardiogenic shock due to sustained VT/Vf after CABG may be an indication for ECMO support. Immediate establishment of circulatory support using ECMO provides valuable time for spontaneous and interventional correction of reversible causes of sustained VT/Vf.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Chen
authors.forename: Wen-Je
authors.initials: WJ
authors.lastname: Ko
authors.forename: Fang-Yue
authors.initials: FY
authors.lastname: Lin
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000628:therapy*