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ECMO and congenital heart disease
1Wake Forest University School of Medicine, Brenner Children's Hospital and Wake Forest University/Baptist Medical Center, Winston-Salem, NC, USA. mhines@wfubmc.edu
Seminars in Perinatology
|June 1, 2005
Summary
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is crucial for congenital heart disease, offering vital support for infants and improving outcomes for complex conditions. This life-saving technology has expanded its applications over two decades.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Venoarterial extracorporeal membrane oxygenation (VA ECMO) was initially for respiratory failure.
- Its application has expanded significantly in treating pediatric congenital heart disease.
- VA ECMO provides essential support for infants with myocardial dysfunction.
Purpose of the Study:
- To review the expanded applications and benefits of VA ECMO in congenital heart disease.
- To highlight VA ECMO's role in preoperative and postoperative management.
- To discuss its utility as a bridge to transplantation and in specific surgical scenarios.
Main Methods:
- Review of clinical applications and outcomes of VA ECMO in pediatric congenital heart disease.
- Analysis of VA ECMO's role in managing pulmonary hypertension and other complex lesions.
- Evaluation of extracorporeal cardiopulmonary resuscitation (ECPR) in salvageable pediatric cases.
Main Results:
- VA ECMO significantly improves outcomes for conditions like total anomalous pulmonary venous connection.
- It serves as a viable bridge to cardiac transplantation for small infants.
- Rescue ECMO (ECPR) demonstrates salvageability in decompensated pediatric patients.
Conclusions:
- VA ECMO is a critical, life-saving therapy for congenital heart disease.
- Technological advancements have expanded its use and improved patient outcomes.
- It offers unique advantages in specific surgical interventions and critical care scenarios.