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J Thorac Cardiovasc Surg 2005;130:595-596
© 2005 The American Association for Thoracic Surgery

Brief Communication

Left atrial decompression by percutaneous cannula placement while on extracorporeal membrane oxygenation

Medical University of South Carolina, Charleston, SC

Received for publication November 18, 2004; accepted for publication December 23, 2004.

^_* Address for reprints: Anthony Marcus Hlavacek, MD, Fellow, Department of Pediatric Cardiology, 165 Ashley Ave, PO Box 250915, Charleston, SC 29425 (Email: hlavace@musc.edu).

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

Venoarterial extracorporeal membrane oxygenation (ECMO) is often used in pediatric patients with severe myocardial dysfunction, typically after cardiac surgery, or in patients with acute myocarditis. A problem frequently encountered in these patients is left atrial hypertension, which may result in pulmonary edema, ventricular distention, and subendocardial ischemia. ^1,2 Decompression of the left atrium (LA) will reduce diastolic pressures in the left heart, resulting in an improvement in coronary perfusion and lessen pulmonary edema. We describe the percutaneous placement of a venous cannula in the LA while on ECMO in a child with severe cardiac dysfunction as a result of myocarditis.

Clinical Summary

A 9-year-old boy, weighing 38 kg, was transferred to our institution with severe cardiac dysfunction as a result of biopsy-proven myocarditis. Three days after admission, his cardiac function continued to deteriorate, and venoarterial ECMO was instituted through the right internal jugular vein and right carotid artery. Four days after . . . [Full Text of this Article]

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