Extracorporeal membrane oxygenation as a bridge to definite surgery in recurrent postinfarction ventricular septal defect.
A recurrent shunt after a postinfarction ventricular septal defect (PI-VSD) repair is common. We treated a case of cardiogenic shock caused by a large recurrent shunt after the patch repair of an apical PI-VSD with percutaneous extracorporeal membrane oxygenation (ECMO) for 4 days until a secondary definite repair. This suggests that percutaneous ECMO support is reliable before and after secondary definitive surgery in recurrent PI-VSD and may imply using a delayed surgical strategy with ECMO support to restore hemodynamic stability and avoid primary surgery on freshly fragile infarcted myocardium.
Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
Meng-Ta
MT
Tsai
Hsuan-Yin
HY
Wu
Shih-Hung
SH
Chan
Chwan-Yau
CY
Luo
D000368:Aged; D005112:Extracorporeal Circulation / Q000379:methods*; D006352:Heart Ventricles / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D010477:Perfusion; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000628:therapy; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000628:therapy; D018658:Ventricular Septal Rupture / Q000601:surgery / Q000628:therapy*