Veno-Venous Extracorporeal Membrane Oxygenation for Acute Lung Injury after Surgery for Aortic Dissection: A Case Report

Abstract

Acute respiratory failure after surgery for aortic dissection is a serious complication that has been associated with increased mortality and morbidity. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is reported as one of the treatments for this life-threatening complication. A 78-year-old male patient was admitted to our hospital for Stanford type A acute aortic dissection. He underwent emergency replacement of the ascending aorta, after which he developed acute lung injury. It was difficult to maintain oxygenation with a respirator mask. Therefore, VV-ECMO was initiated on postoperative day 1. The oxygenation gradually improved, and VV-ECMO was continued until postoperative day 13. On postoperative day 25, mechanical ventilation was withdrawn. The patient was discharged from the hospital on postoperative day 149. We report a case of successful treatment of acute lung injury with VV-ECMO initiated after surgery for aortic dissection. VV-ECMO can be considered as a treatment option for severe acute lung injury after surgery for aortic dissection.

Short-term prone positioning for severe acute respiratory distress syndrome after cardiopulmonary bypass: A case report and literature review

“…The EOLIA trial showed that in very severe ARDS, the mortality rate was 35% in patients treated with ECMO compared to 46% in patients without ECMO support[ 28 ]. Kono et al [ 29 ] reported a case that they chose V-V ECMO for Severe Respiratory Failure after Acute Aortic Dissection Surgery. Although PP and ECMO are both options for severe ARDS, ECMO is often not available in general healthcare centers and can easily cause fatal bleeding in patients with abnormal coagulation function.…”