Mitral valve replacement through mini sternotomy after long ECMO course: Case report

Area of Science:

• Cardiology
• Critical Care Medicine
• Cardiovascular Surgery

Background:

• Severe mitral regurgitation (MR) often necessitates surgical intervention, but critically ill patients present management challenges.
• Respiratory failure, particularly in the context of severe sepsis and COVID-19, can complicate the care of patients with severe MR.

Observation:

• A patient with pneumonia, severe sepsis, and multi-organ failure presented with severe MR.
• The patient required mechanical ventilation and prolonged Veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) for 29 days due to respiratory failure.
• Mitral valve replacement was successfully performed after the patient was stabilized and weaned from VV-ECMO.

Findings:

• Long-term VV-ECMO served as a crucial bridge for stabilizing a critically ill patient with severe MR and respiratory failure.
• This strategy facilitated the eventual successful mitral valve replacement.

Implications:

• The use of long-term VV-ECMO can be a viable approach to manage critically ill patients with severe MR and respiratory failure.
• Further research is needed to determine the long-term outcomes and optimal timing for intervention in such complex cases.