title: Mechanical support for pulmonary veno-occlusive disease: combined atrial septostomy and venovenous extracorporeal membrane oxygenation.
abstract: The use of atrial septostomy for refractory pulmonary hypertension and right ventricular failure results in an adequate left ventricular preload and improved cardiac output at the expense of a profound hypoxic shunt. Combined dual-lumen venovenous extracorporeal membrane oxygenation and atrial septostomy provides extracorporeal gas exchange of venous return before the directional right atrial to left atrial shunt, can be deployed percutaneously, and results in an ambulatory patient with stable hemodynamics.
authors.affiliation: Department of Surgery, Section of Transplantation, University of Kentucky College of Medicine, Lexington, Kentucky 40536-0284, USA. charles.hoopes@uky.edu
authors.forename: Charles W
authors.initials: CW
authors.lastname: Hoopes
authors.forename: John C
authors.initials: JC
authors.lastname: Gurley
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Zwischenberger
authors.forename: Enrique
authors.initials: E
authors.lastname: Diaz-Guzman
mesh_terms: D054087:Atrial Septum / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures; D018618:Echocardiography, Doppler, Color; D015199:Extracorporeal Membrane Oxygenation; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000628:therapy; D010030:Ostomy; D011652:Pulmonary Circulation; D011668:Pulmonary Veno-Occlusive Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right