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: Kunio Kusajima, Takaya Hoashi, Koji Kagisaki, Kotaro Yoshida, Takayuki Nishigaki, Teruyuki Hayashi, Hajime Ichikawa
• Journal: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs (J Artif Organs) Vol. 17 Issue 1 Pg. 99-102 (Mar 2014) ISSN: 1619-0904 [Electronic] Japan
• PMID: 24379041 (Publication Type: Case Reports, Journal Article)

Topics

• Child, Preschool
• Extracorporeal Membrane Oxygenation (instrumentation)
• Fatal Outcome
• Female
• Heart Defects, Congenital (complications, surgery)
• Humans
• Postoperative Complications (therapy)
• Protein-Losing Enteropathies (complications)