Extracorporeal membrane oxygenation support during repair of traumatic aortic transection

Acute traumatic aortic transection is a critical condition in victims of major trauma. How to avoid the complications of surgical repair is still a challenge to trauma and cardiovascular surgeons. A 74-year-old woman was referred to our hospital with multiple fractures and hypotension after a motor vehicle accident. Computed tomography revealed acute traumatic aortic transection at the upper thoracic aorta with periaortic hematoma. She underwent repair of the aortic injury after primary survey. The patient received urgent aortic grafting under heparin-free extracorporeal membrane oxygenation support for lower body perfusion. The postoperative course was smooth. No neurologic or hemorrhagic complication was noted. The results of this case indicate that extracorporeal membrane oxygenation could be used as a heparin-free partial bypass system during surgery for traumatic aortic transection. The risk of spinal cord ischemia during aortic clamp or bleeding due to heparinization during conventional cardiopulmonary bypass could be minimized.