title: Veno-Arterial ECMO in the Setting of Post-Infarct Ventricular Septal Defect: A Bridge to Surgical Repair.
abstract: Extracorporeal membrane oxygenation (ECMO) is a complex rescue therapy utilised to provide circulatory and/or respiratory support to critically ill patients who have failed maximal conventional therapy. The use of ECMO in adult cardiac surgery is not routine, occurring in a minority of critically ill patients, typically postoperatively. Presented here are three cases of post-infarct ventricular septal defect with cardiogenic shock managed preoperatively with ECMO support as a bridge to definitive surgical closure. We present a review of ECMO in the adult cardiac surgical population and highlight the potential role of preoperative ECMO for cardiogenic shock in the setting of post-infarct ventricular septal defect (PI VSD) as a bridge to definitive closure.
authors.affiliation: Department of Intensive Care, St Andrew's War Memorial Hospital, Brisbane, Qld, Australia. Electronic address: aden.mclaughlin@hotmail.com.
authors.forename: Aden
authors.initials: A
authors.lastname: McLaughlin
authors.affiliation: Cardiothoracic Surgery and Transplantation, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: David
authors.initials: D
authors.lastname: McGiffin
authors.affiliation: Department of Intensive Care, Gold Coast University Hospital, Gold Coast, Qld, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Winearls
authors.affiliation: Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Qld, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Tesar
authors.affiliation: Department of Cardiothoracic Surgery, The Princess Alexandra Hospital, Brisbane, Qld, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cole
authors.affiliation: Department of Cardiothoracic Surgery, The Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Vallely
authors.affiliation: Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Qld, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Clarke
authors.affiliation: Department of Intensive Care, The Prince Charles Hospital, Brisbane, Qld, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Fraser
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D012770:Shock, Cardiogenic / Q000503:physiopathology / Q000517:prevention & control
keywords: ECMO; Post-infarct ventricular septal defect