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Ann Thorac Surg 2001;71:735-736
© 2001 The Society of Thoracic Surgeons

How to do it

Use of ECMO without the oxygenator to provide ventricular support after Norwood Stage I procedures

Edward M. Darling, CCPa, David Kaemmer, CCPa, Dale Scott Lawson, CCPa, James J. Jaggers, MDb, Ross M. Ungerleider, MDb

a Divisions of Perfusion Services, Duke University Medical Center and Health Systems, Durham, North Carolina, USA
b Thoracic Surgery, Duke University Medical Center and Health Systems, Durham, North Carolina, USA

Accepted for publication June 2, 2000.

Address reprint requests to Dr Ungerleider, Division of Cardiothoracic Surgery, L-353, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97201-3098

Extracorporeal membrane oxygenation (ECMO) has been found effective in supporting infants with severe cardiac dysfunction following open heart surgery. Centers using this mode of support can also, in instances of single ventricle morphology, consider the option of eliminating the oxygenator from the standard ECMO set-up and thereby provide roller pump ventricular assist. In these cases, the infant’s own lungs can provide excellent oxygenation simply by leaving the aortopulmonary shunt open. Since ventricular support ensures maintenance of normal cardiac output, manipulation of pulmonary versus systemic flows is not necessary. This configuration retains the safety features of the ECMO system and is easily staffed by the ECMO support personnel. There may be several benefits to employing this type of management.




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