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Jorge L. Simon
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J Thorac Cardiovasc Surg 2004;127:1200-1202
© 2004 The American Association for Thoracic Surgery

Brief communication

A simplified technique for short-term postcardiotomy pediatric extracorporeal membrane oxygenation

Christián Kreutzer, MDa,*, Graciela Zapico, CCPa, Christian Blunda, MDa, Maria I. Roman, MDa, Willy M. Conejeros, MDa, Adrian D. Revora, MDa, Jorge L. Simon, MDa, Andres J. Schlichter, MDa, Guillermo O. Kreutzer, MDa

a Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA

Received for publication May 12, 2003; accepted for publication May 16, 2003.

* Address for reprints: Christián Kreutzer, Instructor in Cardiovascular Surgery, Division of Cardiovascular Surgery, Ricardo Gutierrez Children's Hospital, MD Gallo 1330, 1425 Buenos Aires, Argentina
ckreutz@intramed.net.ar

The first 20% of the full text of this article appears below.


Kreutzer


In the current era, extracorporeal membrane oxygenation (ECMO) is one of the appropriate tools for cardiopulmonary mechanical support after reparative surgery for congenital heart disease.1,2 Mechanical support is specially indicated for lesions and procedures in which transient postoperative myocardial dysfunction is expected and there is a reasonable chance of recovery.3 The usual postcardiotomy ECMO technique involves the replacement of the conventional extracorporeal circuit with a special closed ECMO circuit and oxygenator. We describe a modification of the cardiopulmonary bypass (CPB) circuit to create a closed ECMO circuit for short-term support, by using the standard parts of a conventional CPB circuit.

Patients and methods

From November 2001 to June 2003, a specially designed CPB circuit was indicated in 13 patients in whom the possible need of postoperative ECMO was expected. The indications were anomalous left coronary artery arising from pulmonary artery, hypoplastic left heart syndrome, D transposition of the great arteries older than 4 weeks, and preoperative severe heart failure with inotropic use and assisted ventilation. Four patients (Table 1) who could . . . [Full Text of this Article]






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