Extracorporeal Membrane Oxygenation as a Bridge to Surgery for Infective Endocarditis Complicated by Aorto-Atrial Fistula and Cardiopulmonary Collapse.
The timing of surgery for active infective endocarditis is challenging when patients exhibit mechanical dysfunction and hemodynamic compromise. Extracorporeal membrane oxygenation has been described in treating sepsis but not, insofar as we know, in treating the acute mechanical sequelae that arise from infective endocarditis. We report perhaps the first case that shows the usefulness of extracorporeal membrane oxygenation as a bridge to definitive treatment in a 35-year-old man who had infective endocarditis followed by aorto-atrial fistula and cardiopulmonary collapse.
Adam M
AM
Noyes
Bhavadharini
B
Ramu
Matthew W
MW
Parker
David
D
Underhill
Jason A
JA
Gluck
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001018:Aortic Diseases / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D002315:Cardiopulmonary Bypass; D003646:Debridement; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D015199:Extracorporeal Membrane Oxygenation; D006331:Heart Diseases / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D058386:Mitral Valve Annuloplasty; D012769:Shock / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D015819:Substance Abuse, Intravenous / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D034363:Viridans Streptococci / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents
Aortic valve insufficiency/etiology/surgery; debridement; endocarditis, bacterial/complications/surgery; extracorporeal membrane oxygenation/trends; heart valve diseases/complications; infective endocarditis; shock, cardiogenic/therapy; shock, septic; substance abuse, intravenous/complications