초록접수 현황
| 14F-123 | 포스터 발표 |
ECMO used as a Long Term Bridge to Heart Transplantation in Acute Left Ventricular Infarction Patient
정윤상, 조대윤, 손동섭, 최주원, 홍준화
중앙대학교 의과대학 흉부외과학교실
Background : Due to the technical advances in pumps, oxygenators and cannulas, veno-arterial extracorporeal membrane oxygenation (VA ECMO) has been widely used in emergency medicine and intensive care medicine for several years. It provides enough time for the affected organ to recover (bridge to recovery) or for a long-lasting organ substitution by a left ventricular assist device (LVAD) or by transplantation. However, as implantable LVAD is not easily available in Korea, some of heart failure patients need to be supported with ECMO longer than in other countries until the patients get donor hearts. We report a case of long term VA ECMO support as a bridge to transplantation.
Methods : An 53 year old male patient presented to emergency room for sudden chest pain. He was brought to coronary intervention laboratory. Stent was placed into the left main coronary artery under VA ECMO support. However, myocardial recovery was not successful. Several attempts of ECMO weaning were failed due to severe left ventricular dysfunction (EF 10-15%) and subsequent organ dysfunction and pulmonary edema. We decided to enroll the patient on the waiting list for heart transplantation. Patient had been awaken, non-intubated for 21 days while he was on ECMO support for better emotional, nutritional care, hygiene, and to avoid the complications associated with intubation and prolonged mechanical ventilation. After 35 days, an appropriate organ became available. The patient underwent heart transplantation and dismissed without major complications.
Conclusion : ECMO can provide a long enough time for bridge to heart transplantation. Meticulous care must be taken to provide enough circulatory, nutritional and emotional support and to prevent any major complications from a prolonged ICU care and ECMO application.
Methods : An 53 year old male patient presented to emergency room for sudden chest pain. He was brought to coronary intervention laboratory. Stent was placed into the left main coronary artery under VA ECMO support. However, myocardial recovery was not successful. Several attempts of ECMO weaning were failed due to severe left ventricular dysfunction (EF 10-15%) and subsequent organ dysfunction and pulmonary edema. We decided to enroll the patient on the waiting list for heart transplantation. Patient had been awaken, non-intubated for 21 days while he was on ECMO support for better emotional, nutritional care, hygiene, and to avoid the complications associated with intubation and prolonged mechanical ventilation. After 35 days, an appropriate organ became available. The patient underwent heart transplantation and dismissed without major complications.
Conclusion : ECMO can provide a long enough time for bridge to heart transplantation. Meticulous care must be taken to provide enough circulatory, nutritional and emotional support and to prevent any major complications from a prolonged ICU care and ECMO application.
책임저자: 홍준화
중앙대학교 의과대학 흉부외과학교실
연락처 : 정윤상, Tel: 02-6299-1635 , E-mail : yoonc@hotmail.com
