Recent advances in veno-arterial (VA) and veno-venous (VV) extracorporeal membrane oxygenation (ECMO) technology and management have enabled us to support patients with cardiac and/or pulmonary failure, who may have previously been considered untreatable. VA ECMO and VV ECMO are by definition transient therapies and serve as a bridge to recovery, bridge to decision, bridge to transplant, or bridge to no recovery. Weaning ECMO should be considered for all patients once native cardiac and pulmonary function show signs of recovery. Currently, there are no universally accepted protocols for weaning VA and VV ECMO, and consequently, each individual center follows their own weaning protocols. The aim of this review article is to describe different approaches to safely wean from VA and VV ECMO.
Ascending aortic pseudoaneurysms are an infrequent but life-threatening complication of cardiac and aortic surgery. Although rare, these pseudoaneurysms can form as a complication of penetrating atherosclerotic ulcers. We report a case of a ruptured penetrating atherosclerotic ulcer repaired percutaneously with an Amplatzer Atrial Septal Occluder (Abbott, Plymouth, MN, USA).
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