Veno-arterial extracorporeal membrane oxygenation for high-risk cardiac catheterisation procedures.
Extracorporeal membrane oxygenation (ECMO) provides circulatory or respiratory support, or both, to patients with severe but potentially reversible cardiac or respiratory failure refractory to standard therapy. The use of ECMO in the paediatric cardiac surgical population is established. Likewise, the use of ECMO for severe adult respiratory failure has recently been established and has been the subject of recent clinical trials. However, its use as a means of cardiac support in the adult population is not routine in clinical practice. We herein review the indications, technical procedure, complications and outcomes of extracorporeal membrane oxygenation as pertinent to cardiac disease in general, and specifically, to catheter-based interventions. We describe two cases of high-risk cardiac catheterisation laboratory procedures performed with veno-arterial ECMO support in adult patients who were deemed to be at unacceptably high risk for conventional open-heart surgery and cardiopulmonary bypass.
Spina
Roberto
R
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
Forrest
A P
AP
Adams
Mark R
MR
Wilson
Michael K
MK
Ng
Martin K
MK
Vallely
Michael P
MP
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D006328:Cardiac Catheterization / Q000009:adverse effects*; D000075202:Contraindications; D003324:Coronary Artery Disease / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D016896:Treatment Outcome