title: Preoperative ECMO in transposition of the great arteries with persistent pulmonary hypertension.
abstract: 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.
authors.affiliation: Services de Chirurgie Thoracique, CHRU de Lille, Lille, France. sjaillard@chru-lille.fr
authors.forename: Sophie
authors.initials: S
authors.lastname: Jaillard
authors.forename: Emre
authors.initials: E
authors.lastname: Belli
authors.forename: Thameur
authors.initials: T
authors.lastname: Rakza
authors.forename: Benoit
authors.initials: B
authors.lastname: Larrue
authors.forename: Eric
authors.initials: E
authors.lastname: Magnenant
authors.forename: Christian
authors.initials: C
authors.lastname: Rey
authors.forename: Laurent
authors.initials: L
authors.lastname: Storme
mesh_terms: 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*