Preoperative ECMO in transposition of the great arteries with persistent pulmonary hypertension.
Persistent fetal circulation in transposition of the great arteries results in severe persistent pulmonary hypertension, which increases the risk of early mortality. We report the case of a newborn with transposition of the great arteries and intact ventricular septum associated with pulmonary hypertension. After the failure of immediate balloon atrial septostomy and supportive therapy including inhaled nitric oxide, preoperative extracorporeal membrane oxygenation reversed pulmonary hypertension and ventricular insufficiency and preceded a safe, delayed, cardiac surgical procedure. Unlike the authors of the other few case reports on this subject, we recommend a preoperative stabilization period after discontinuation of extracorporeal membrane oxygenation to avoid left ventricular "deconditioning" and postoperative deterioration related to recurrent persistent pulmonary hypertension.
Jaillard
Sophie
S
Services de Chirurgie Thoracique, CHRU de Lille, Lille, France. sjaillard@chru-lille.fr
Belli
Emre
E
Rakza
Thameur
T
Larrue
Benoit
B
Magnenant
Eric
E
Rey
Christian
C
Storme
Laurent
L
D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000150:complications*