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Right arrow Extracorporeal circulation

J Thorac Cardiovasc Surg 2007;133:1680-1681
© 2007 The American Association for Thoracic Surgery

Brief Communication

Extracorporeal membrane oxygenation with direct central cannulation followed by delayed chest closure for graft dysfunction after lung transplantation: Report of two cases with pulmonary arterial hypertension

Masayoshi Inoue, MD, PhD*, Masato Minami, MD, PhD, Hajime Ichikawa, MD, PhD, Norihide Fukushima, MD, PhD, Hiroyuki Shiono, MD, PhD, Tomoki Utsumi, MD, PhD, Meinoshin Okumura, MD, PhD, Yoshiki Sawa, MD, PhD

Osaka University Graduate School of Medicine, Osaka, Japan.

Received for publication October 24, 2006; accepted for publication December 12, 2006.

* Address for reprints: Masayoshi Inoue, MD, PhD, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, E1-2-2 Yamadaoka Suita-city, Osaka 565-0871, Japan. (Email: masa@surg1.med.osaka-u.ac.jp).

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

Extracorporeal membrane oxygenation (ECMO) has been reported to be effective for posttransplant pulmonary dysfunction, which is occasionally fatal.1,2Go We report 2 cases with pulmonary arterial hypertension (PAH), who were successfully treated with ECMO with direct central cannulation for graft dysfunction after lung transplantation. We also provide details regarding our delayed chest closure procedure, which contributed to posttransplant management.

Clinical Summary

Patient 1
A female patient was diagnosed with PAH at the age of 7 years. Because hemoptysis was found, living donor lung transplantation was scheduled at age 11. The patient had a status of New York Heart Association (NYHA) IV and was treated with O2 2 L/min, epoprostenol (20 ng · kg–1 · min–1), and sildenafil (57 mg/d), as well as diuretics and anticoagulants. Her chest radiograph showed cardiomegaly with 62% of the cardiothoracic ratio (CTR). Ultrasound cardiography (UCG) revealed tricuspid valve regurgitation of 3/4. Pulmonary arterial pressure was measured as 103/50 (71) mm Hg with cardiac catheterization. The patient underwent living donor bilateral lobe lung transplantation from both of her parents. The . . . [Full Text of this Article]






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