| Title | Preoperative extracorporeal membrane oxygenation as a bridge to cardiac surgery in children with congenital heart disease. | | Author(s) | Bautista-Hernandez V, Thiagarajan RR, Fynn-Thompson F, Rajagopal SK, Nento DE, Yarlagadda V, Teele SA, Allan CK, Emani SM, Laussen PC, Pigula FA, Bacha EA | | Institution | Department of Cardiac Surgery, Children's Hospital Boston, Boston, Massachusetts 02115, USA. | | Source | Ann Thorac Surg 2009 Oct; 88(4):1306-11. | | MeSH | Cardiac Surgical Procedures
Child
Child, Preschool
Extracorporeal Membrane Oxygenation
Female
Follow-Up Studies
Heart Defects, Congenital
Heart Failure
Humans
Infant
Infant, Newborn
Male
Massachusetts
Preoperative Care
Retrospective Studies
Survival Rate
| | Abstract | BACKGROUND: The efficacy of extracorporeal membrane oxygenation (ECMO) in bridging children with unrepaired heart defects to a definitive or palliative surgical procedure has been rarely reported. The goal of this study is to report our institutional experience with ECMO used to provide preoperative stabilization after acute cardiac or respiratory failure in patients with congenital heart disease before cardiac surgery.
METHODS: A retrospective review of the ECMO database at Children's Hospital Boston was undertaken. Children with unrepaired congenital heart disease supported with ECMO for acute cardiac or respiratory failure as bridge to a definitive or palliative cardiac surgical procedure were identified. Data collection included patient demographics, indication for ECMO, details regarding ECMO course and complications, and survival to hospital discharge.
RESULTS: Twenty-six patients (18 male, 8 female) with congenital heart disease were bridged to surgical palliation or anatomic repair with ECMO. Median age and weight at ECMO cannulation were, respectively, 0.12 months (range, 0 to 193) and 4 kg (range, 1.8 to 67 kg). Sixteen patients (62%) survived to hospital discharge. Variables associated with mortality included inability to decannulate from ECMO after surgery (p = 0.02) and longer total duration of ECMO (p = 0.02). No difference in outcomes was found between patients with single and biventricular anatomy.
CONCLUSIONS: Extracorporeal membrane oxygenation, used as a bridge to surgery, represents a useful modality to rescue patients with failing circulation and unrepaired complex heart defects. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
| | PubMed ID | 19766826 |
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