Total reversal of the pulmonary circulation (RPC) induced by peripheral cannulation for veno-arterial ECMO in a patient with aortic and mitral valve insufficiency: a case report.

Autor: Heymer J; Internal Medicine Intensive Care, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany., Bent D; Internal Medicine Intensive Care, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany., Raepple D; Internal Medicine Intensive Care, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany. d.raepple@klinikum-stuttgart.de.
Jazyk: angličtina
Zdroj: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs [J Artif Organs] 2024 Dec 13. Date of Electronic Publication: 2024 Dec 13.
DOI: 10.1007/s10047-024-01483-7
Abstrakt: This case report details a rare instance of total reversal of the pulmonary circulation (RPC) in a 56-year-old male patient on veno-arterial extracorporeal membrane oxygenation (V-A ECMO) during emergency cardiopulmonary resuscitation (eCPR) following a myocardial infarction and cardiac arrest. Previously unrecognized aortic and mitral valve regurgitations, along with V-A ECMO flow, resulted in severe pulmonary edema. We describe how pulmonary artery cannulation and modifying the ECMO circuit to veno-pulmonary arterial-arterial (VPa-A) ECMO successfully alleviated the severe pulmonary edema but may have caused reversal of the pulmonary circulation (RPC). To our knowledge, this is the first reported case of this phenomenon in a human.
Competing Interests: Declarations. Conflict of interest: Johannes Heymer, Daniel Bent: None. Daniel Raepple: Book royalties from Springer, Heidelberg. Travel grant Abiomed.
(© 2024. The Author(s), under exclusive licence to the Japanese Society for Artificial Organs.)
Databáze: MEDLINE
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