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Efficacy of extracorporeal membrane oxygenation in a congenital heart surgery program

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Summary

Background

To report our experience with extracorporeal membrane oxygenation (ECMO) in a congenital heart surgery program.

Methods

Since 12/1996, 24 patients (8 newborns, 9 infants, 3 children, 4 adolescents/ adults 17–23 years), mean age 4.0±7.4 years (2 days–23 years), body weight 2.7–87 kg had ECMO as circulatory support. Indication was failure to wean from cardiopulmonary bypass in the majority of cases.

Results

Mean duration of support was 3.8±2.9 d (12 h–13 d). Fourteen patients were weaned from ECMO (9 discharged), three successfully transplanted (one after switching to a pulsatile assist device). One patient on left-ventricular support required ECMO for sudden rightventricular failure (decreased). There were six deaths on ECMO due to multiorgan failure (MOV) (3) or no myocardial recovery (3). Six patients died after weaning (3 MOV, 2 myocardial failure, 1 fungal sepsis). Overall, twelve patients (50%) were discharged and are clinically well after 3.4±2.4 years (0.8–7.2 years).

Conclusion

In our series, ECMO markedly reduces mortality in patients who would otherwise not survive either open heart surgery or myocardial failure of any origin and was not associated with discernible morbidity in the midterm.

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References

  1. Baffes TG, Fridman JL, Bicoff JP, Whitehill JL (1970) Extracorporeal circulation for support of palliative cardiac surgery in infants. Ann Thorac Surg 10:354–363

    Article  CAS  PubMed  Google Scholar 

  2. Ahron AS, Dinkwater DC, Churchwell KB et al (2001) Extracorporeal membrane oxygenation in children after repair of congenital cardiac lesions. Ann Thorac Surg 72:2095–2102

    Article  Google Scholar 

  3. Montgomery VL, Strotman JM, Ross MP (2000) Impact of multi organ system dysfunction and nosocomial infections on survival of children treated with extracorporeal membrane oxygenation after heart surgery. Crit Care Med 28:526–531

    Article  CAS  PubMed  Google Scholar 

  4. Morris MC, Ittenbach RF, Godinez RI et al (2004) Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation. Crit Care Med 32(4):1061–1069

    Article  PubMed  Google Scholar 

  5. Anonymous (2003) ECMO Registry of the Extracorporeal Life Support Organization (ELSO). Ann Arbor, MI, January 2003

  6. Del Nido PJ (1996) Extracorporeal membrane oxygenation for cardiac support in children. Ann Thorac Surg 61:336–339

    Article  CAS  PubMed  Google Scholar 

  7. Duncan BW, Hraska V, Jonas RA et al (1999) Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg 117:529–542

    Article  CAS  PubMed  Google Scholar 

  8. Duncan BW, Ibrahim AE, Hraska V et al (1998) Use of rapid-deployment extracorporeal membrane oxygenation for the resuscitation of pediatric patients with heart disease after cardiac arrest. J Thorac Cardiovasc Surg 116:305–311

    Article  CAS  PubMed  Google Scholar 

  9. Jaggers JJ, Forbess JM, Shah AS et al (2000) Extracorporeal membrane oxygenation for infant postcardiotomy support: significance of shunt management. Ann Thorac Surg 69:1476–1483

    Article  CAS  PubMed  Google Scholar 

  10. Kolovos NS, Bratton SL, Moler FW et al (2003) Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery. Ann Thorac Surg 76(5):1435–1441

    Article  PubMed  Google Scholar 

  11. Chaturvedi RR, Macrae D, Brown KL et al (2004) Cardiac ECMO for biventricular hearts after pediatric open heart surgery. Heart 90(5):545–551

    Article  CAS  PubMed  Google Scholar 

  12. Ibrahim AE, Duncan BW, Blume ED et al (2000) Long-term follow-up of pediatric cardiac patients requiring mechnical circulatory support. Ann Thorac Surg 69:186–192

    Article  CAS  PubMed  Google Scholar 

  13. Hadem J, Schroder F, Winkler T et al (2006) One day from dyspnea to death: unsuccessful application of extracorporeal membrane oxygenation in toxoplasma myocarditis following bone marrow transplantation. Clin Res Cardiol 95(9):477–481

    Article  CAS  PubMed  Google Scholar 

  14. The hypothermia after cardiac arrest study group (2002) Mild therapeutic hypothermia to improve neurologic outcome after cardiac arrest. New Engl J Med 346:549–556

    Article  Google Scholar 

  15. Kihara S, Kawai A, Endo M, Koyanagi H, Kurosawa H (2002) Extracorporeal membrane oxygenation and left ventricular assist device: a case of double mechanical bridge. Heart Vessels 16(4):164–166

    Article  PubMed  Google Scholar 

  16. Kulik TJ, Moler FW, Palmisano JM et al (1996) Outcome-associated factors in pediatric patients treated with extracoporeal membrane oxygenation after cardiac surgery. Circulation 94 (Suppl 2):II-63–68

    CAS  Google Scholar 

  17. Walters HL, Hakimi M, Rice MD, Lyons JM, Whittlesey GC, Klein MD (1995) Pediatric cardiac surgical ECMO: multivariate analysis of risk factors for hospital death. Ann Thorac Surg 60:329–337

    Article  PubMed  Google Scholar 

  18. Hammrick SEG, Gremmels DB, Keet CA et al (2003) Neurodevelopmental outcome of infants supported with extracorporeal membrane oxygenation after cardiac surgery. Pediatrics 111:671–675

    Article  Google Scholar 

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Authors and Affiliations

  1. Pediatric Cardiac Surgery, University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany

    Jörg S. Sachweh MD, Andreas R. Tiete, Bruno Reichart & Sabine H. Däbritz

  2. Department of Cardiac Surgery and Department of Pediatric Cardiology, Ludwig-Maximilians University, Klinikum Großhadern, München, Germany

    Alexandra Fuchs, Ulrich Römer & Reiner Kozlik-Feldmann

Authors
  1. Jörg S. Sachweh MD
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  2. Andreas R. Tiete
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  3. Alexandra Fuchs
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  4. Ulrich Römer
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  5. Reiner Kozlik-Feldmann
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  6. Bruno Reichart
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  7. Sabine H. Däbritz
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Correspondence to Jörg S. Sachweh MD.

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Sachweh, J.S., Tiete, A.R., Fuchs, A. et al. Efficacy of extracorporeal membrane oxygenation in a congenital heart surgery program. Clin Res Cardiol 96, 204–210 (2007). https://doi.org/10.1007/s00392-007-0484-1

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  • DOI: https://doi.org/10.1007/s00392-007-0484-1

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