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The Annals of Thoracic Surgery, Vol 48, 206-212, Copyright © 1989 by The Society of Thoracic Surgeons
L Weinhaus, C Canter, M Noetzel, W McAlister and TL Spray
Extracorporeal membrane oxygenation was used for cardiovascular support in
13 infants and children with complex congenital heart disease and 1
premature neonate treated in preparation for pericardial patch
tracheoplasty for long-segment tracheal stenosis. Nine patients were weaned
from extracorporeal membrane oxygenation. There were five (36%) early
deaths and four (29%) late deaths. Cannulation sites included right
carotid/jugular vessels, femoral artery and vein, and right atrium and
aorta. In 4 patients, the neck vessels were repaired at decannulation. Five
survivors had normal growth and neurodevelopmental evaluations at
follow-up. Extracorporeal membrane oxygenation can be successfully used as
biventricular support in patients with intractable low cardiac output
syndrome after repair of congenital heart disease. Best results are
obtained in patients who have several hours of stability after operation
before initiation of support. Hemorrhagic complications are reduced and
long-term neurodevelopmental outcomes appear promising with right neck
vessel cannulation and repair. No bleeding complications were observed in
patients cannulated through the neck vessels.
ARTICLES
Extracorporeal membrane oxygenation for circulatory support after repair of congenital heart defects
Division of Pediatric Cardiology, St. Louis Children's Hospital, Washington University Medical Center, Missouri 63110.
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