title: Successful extracorporeal membrane oxygenation weaning after cardiac resynchronization therapy device implantation in a patient with end-stage heart failure.
abstract: We present the case of a 46-year old male with end-stage heart failure due to ethyltoxic cardiomyopathy. The patient did not meet the criteria for heart transplantation and declined left ventricular assist device implantation. We decided to conduct cardiac resynchronization therapy defibrillator (CRT-D) implantation. Under general anaesthesia for CRT-D implantation, cardiac function worsened. Due to deteriorating haemodynamics, CRT-D implantation was aborted and emergent veno-arterial extracorporeal membrane oxygenation (ECMO) implantation was performed. Subsequent weaning from ECMO was not possible. We decided to proceed with CRT-D implantation while still on ECMO support. With biventricular stimulation, cardiac function improved promptly and the patient could be weaned from ECMO the same day.
authors.affiliation: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany. s.pecha@uke.de
authors.forename: Simon
authors.initials: S
authors.lastname: Pecha
authors.forename: Yalin
authors.initials: Y
authors.lastname: Yildirim
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Tobias
authors.initials: T
authors.lastname: Deuse
mesh_terms: D058406:Cardiac Resynchronization Therapy; D058409:Cardiac Resynchronization Therapy Devices; D002310:Cardiomyopathy, Alcoholic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017147:Defibrillators, Implantable; D015199:Extracorporeal Membrane Oxygenation; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D016896:Treatment Outcome; D016276:Ventricular Function