Veno-arterial extracorporeal membrane oxygenation for post-infarction ventricular septal defect in a low-volume center

Abstract

Managing patients with post-ischaemic ventricular septal defects (VSD) and postcardiotomy cardiogenic shock can be extremely challenging in a low-volume cardiac surgery unit. We present a case of a 68-year-old patient who received veno-arterial extracorporeal membrane oxygenation support due to cardiogenic shock after VSD repair. The patient was successfully weaned off support after 86 hours. In the postoperative period, mediastinitis occurred, and negative pressure wound therapy was instituted.

25th anniversary of the Department of Cardiac Surgery at the University Medical Center Maribor: advancing hearts, changing lives

“…We address all adult cardiac and major vascular pathologies (with exceptions such as long-term mechanical support for heart failure and transplantation activities). Our current surgical portfolio includes surgery for ischemic heart diseases (with or without cardiopulmonary bypass, multiarterial grafting, minimally invasive myocardial revascularization [ 3 , 4 ] and surgical treatment of complications, such as ventricular septal defects, myocardial ruptures and left ventricular aneurysms), aortic valve replacement with mechanical or stented bioprostheses, aortic valve repair and valve-sparing aortic root replacement (both reimplantation and remodelling with external annuloplasty) [ 5 ], minimally invasive aortic [ 6 ] and mitral valve surgery [ 7 , 8 ], mitral valve repair and replacement [ 9 ], surgical treatment of any heart valve endocarditis, surgery for tricuspid or pulmonary valve disease, aortic surgery (aortic dissection, ascending and arch aneurysms including the frozen elephant trunk procedure [ 10 ], trauma to the great vessels), surgery for atrial fibrillation [ 11 ], pericardiectomy, surgery for cardiac neoplasms, temporary mechanical circulatory support (intra-aortic balloon pump, extracorporeal membrane oxygenation) [ 12 , 13 ] and carotid endarterectomy. In addition, we provide surgical assistance and standby for various interventional cardiological (percutaneous coronary interventions, transcatheter aortic valve implantations [ 14 , 15 ], interventional treatment for atrial and ventricular arrhythmias) or radiological (thoracic endovascular aortic repair) procedures.…”