초록접수 현황
| 20F-028 | Video session발표 |
Near infrared spectroscopy guided iliac artery thrombectomy during V-A ECMO weaning
Hyoung Woo Chang, Dong Jung Kim, Jun Sung Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
Purpose : We are presenting a video of near infrared spectroscopy (NIRS) guided iliac artery thrombectomy during peripheral V-A ECMO weaning.
Methods : In a 69-year old male patient with ST elevation myocardial infarction, peripheral V-A ECMO was implanted via right femoral vessels during E-CPR. NIRS probes were applied to posterior sides of bilateral calves. As NIRS value decreased on the right side, distal perfusion catheter was inserted. Emergency CABG was performed under ECMO support.
Results : On postoperative day #1, the vital signs were stable with minimal inotropic support and low ECMO flow. Bedside open surgical repair of right common femoral artery was performed. During the operation, NIRS values were balanced and above 40% on both side, but just before closing the wound, marked decrement of NIRS value on the right side was detected. During re-exploration, we found that forward flow from iliac artery was blocked. Iliac artery thrombectomy using Fogarty catheter was performed, and the flow from iliac artery was recovered. After reinstituting the blood flow, NIRS value on the right side recovered and reached balanced state immediately.
Conclusion : Bilateral leg NIRS monitoring during peripheral ECMO helps detecting malperfusion during ECMO weaning procedure. Leg NIRS monitoring should be maintained during ECMO weaning and until recovery of even circulation is confirmed.
Methods : In a 69-year old male patient with ST elevation myocardial infarction, peripheral V-A ECMO was implanted via right femoral vessels during E-CPR. NIRS probes were applied to posterior sides of bilateral calves. As NIRS value decreased on the right side, distal perfusion catheter was inserted. Emergency CABG was performed under ECMO support.
Results : On postoperative day #1, the vital signs were stable with minimal inotropic support and low ECMO flow. Bedside open surgical repair of right common femoral artery was performed. During the operation, NIRS values were balanced and above 40% on both side, but just before closing the wound, marked decrement of NIRS value on the right side was detected. During re-exploration, we found that forward flow from iliac artery was blocked. Iliac artery thrombectomy using Fogarty catheter was performed, and the flow from iliac artery was recovered. After reinstituting the blood flow, NIRS value on the right side recovered and reached balanced state immediately.
Conclusion : Bilateral leg NIRS monitoring during peripheral ECMO helps detecting malperfusion during ECMO weaning procedure. Leg NIRS monitoring should be maintained during ECMO weaning and until recovery of even circulation is confirmed.
책임저자: Dong Jung Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
발표자: Hyoung Woo Chang, E-mail : chang.hyoungwoo@gmail.com