Yen-Nien Lin1,2,3, Yin-Huei Chen4, Huang-Joe Wang1,2, Jui-Sung Hung1, Kuan-Cheng Chang1,2,3, Ping-Han Lo1. 1. Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital. 2. Cardiovascular Research Laboratory, China Medical University Hospital. 3. Graduate Institute of Clinical Medical Science, China Medical University. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital.
Abstract
BACKGROUND: Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients.Methods and Results: We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014. Mean left ventricular ejection fraction was 15%. The cause of cardiogenic shock included 7 cases of ischemic heart disease, 1 of dilated cardiomyopathy, 5 of myocarditis, and 2 of fatal ventricular arrhythmia.The procedures were performed 4.3 days after ECMO. Inoue balloon size was 24-27 mm. LA septostomy were successfully created in 14 patients. Procedure time on average was 36.8 min (range, 15-85 min). There were no procedure-related complications.Radiography on the next day showed rapid resolution of pulmonary edema. CONCLUSIONS: Trans-septal LA decompression by Inoue balloon catheter is a feasible alternative method for adult patients with refractory pulmonary edema under ECMO.
BACKGROUND: Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients.Methods and Results: We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014. Mean left ventricular ejection fraction was 15%. The cause of cardiogenic shock included 7 cases of ischemic heart disease, 1 of dilated cardiomyopathy, 5 of myocarditis, and 2 of fatal ventricular arrhythmia.The procedures were performed 4.3 days after ECMO. Inoue balloon size was 24-27 mm. LA septostomy were successfully created in 14 patients. Procedure time on average was 36.8 min (range, 15-85 min). There were no procedure-related complications.Radiography on the next day showed rapid resolution of pulmonary edema. CONCLUSIONS: Trans-septal LA decompression by Inoue balloon catheter is a feasible alternative method for adult patients with refractory pulmonary edema under ECMO.
Authors: Enzo Lüsebrink; Leonhard Binzenhöfer; Antonia Kellnar; Christoph Müller; Clemens Scherer; Benedikt Schrage; Dominik Joskowiak; Tobias Petzold; Daniel Braun; Stefan Brunner; Sven Peterss; Jörg Hausleiter; Sebastian Zimmer; Frank Born; Dirk Westermann; Holger Thiele; Andreas Schäfer; Christian Hagl; Steffen Massberg; Martin Orban Journal: Clin Res Cardiol Date: 2022-08-20 Impact factor: 6.138
Authors: Ali İhsan Hasde; Mehmet Cahit Sarıcaoğlu; Nur Dikmen Yaman; Çağdaş Baran; Evren Özçınar; Mehmet Çakıcı; Mustafa Bahadır İnan; Ahmet Ruchan Akar Journal: Interact Cardiovasc Thorac Surg Date: 2021-04-08