title: Percutaneous balloon atrioseptostomy for left heart discharge in extracorporeal life support patients with persistent pulmonary edema.
abstract: OBJECTIVE
  In severe myocardial dysfunction, extracorporeal life support (ECLS) can preserve organ perfusion. Occasionally, the high resulting afterload can lead to refractory pulmonary edema. We report our experience with percutaneous balloon atrioseptostomy used in this circumstance to discharge the left heart and prevent worsening pulmonary congestion.
  
  
  RESULTS
  Between October 2002 and December 2009, 5 patients, with a mean age of 39 years, who were under peripheral ECLS underwent percutaneous balloon atrioseptostomy for refractory worsening pulmonary edema as determined by clinical, radiological, and echocardiographic criteria. Myocardial dysfunction was related to drug poisoning in 2 cases and to myocarditis in the 3 others. Atrioseptostomy successfully improved pulmonary edema and echocardiographic indices of left ventricular function in all cases. Four patients were eventually discharged. The fifth patient died in hospital due to multiorgan failure.
  
  
  CONCLUSIONS
  In our experience, percutaneous balloon atrioseptostomy appeared to be a rapid, effective, and minimally invasive technique for offloading the left heart of patients with a reversible cardiac dysfunction under ECLS and suffering from refractory pulmonary edema.
authors: Department of Cardiology, University Hospital of Caen, Caen Cedex, France.
authors: Mathieu
authors: M
authors: Bignon
authors: Vincent
authors: V
authors: Roule
authors: Ziad
authors: Z
authors: Dahdouh
authors: Rémi
authors: R
authors: Sabatier
authors: Thérèse
authors: T
authors: Lognoné
authors: Guillaume
authors: G
authors: Malcor
authors: Moussa
authors: M
authors: Idali
authors: Calin
authors: C
authors: Ivascau
authors: Massimo
authors: M
authors: Massetti
authors: Gilles
authors: G
authors: Grollier
mesh_terms: D000293:Adolescent; D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D009202:Cardiomyopathies / Q000150:complications / Q000601:surgery*; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008020:Life Support Care; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult