title: Clinical experience of more than 2 months usage of extracorporeal membrane oxygenation (Endumo(®)4000) without circuit exchange.
abstract: A 5-year-old girl with right atrial isomerism, complete atrioventricular septal defect, hypoplastic left ventricle, double outlet right ventricle, and mixed-type total anomalous pulmonary venous connection with totally occluded left pulmonary veins presented at our center for fenestrated total cavo-pulmonary connection with an extra cardiac conduit at the age of 3 years. Eleven months after the Fontan completion, she developed protein-losing enteropathy (PLE). Spontaneously closed fenestration was thought to be the cause of the PLE, and she underwent revision of fenestration at the age of 5 years. After the operation, PLE did not improve, and newly developed hypoxemia impaired her systemic ventricular function, leading to the initiation of veno-arterial extracorporeal membrane oxygenation (ECMO) with the Endumo(®) system 18 days after the operation to treat her hemodynamic instability. Although the ECMO circuit was changed three times during the first 8 days, the fourth circuit could be used for 74 days without hemolysis and serum leakage, until the patient unfortunately died 82 days after the operation due to multi-organ failure.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Kusajima
authors.forename: Takaya
authors.initials: T
authors.lastname: Hoashi
authors.forename: Koji
authors.initials: K
authors.lastname: Kagisaki
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishigaki
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hayashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Ichikawa
mesh_terms: D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D017809:Fatal Outcome; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000628:therapy*; D011504:Protein-Losing Enteropathies / Q000150:complications