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Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
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E-CPR: coming back to life.

Shubhadeep Das1,2, Debasis Das3, Nilanjan Dutta4

  • 1Pediatric Cardiac Intensive Care Unit, Narayana Superspeciality Hospital, Howrah, West Bengal India.

Indian Journal of Thoracic and Cardiovascular Surgery
|July 22, 2025
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Summary
This summary is machine-generated.

Extracorporeal cardiopulmonary resuscitation (E-CPR) using rapid venoarterial extracorporeal membrane oxygenation (VA-ECMO) successfully revived a critically ill infant. The patient recovered fully with normalized cardiac function post-treatment.

Keywords:
ALCAPAE-CPRECMO

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Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Anomalous left coronary artery from the pulmonary artery (ALCAPA) can cause severe left ventricular dysfunction.
  • Surgical correction of ALCAPA is complex and carries risks of postoperative complications.
  • Cardiac arrest post-extubation in pediatric cardiac surgery requires rapid and effective resuscitation strategies.

Observation:

  • A 3.5-month-old infant with ALCAPA experienced cardiac arrest after surgical correction and extubation.
  • Conventional cardiopulmonary resuscitation (CPR) was ineffective.
  • Extracorporeal cardiopulmonary resuscitation (E-CPR) using venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated after 70 minutes.

Findings:

  • E-CPR provided hemodynamic stability and maintained end-organ function for 72 hours and 45 minutes.
  • The patient demonstrated significant recovery post-decannulation, with normal neurological status and improved cardiac function.
  • At 6 months post-discharge, left ventricular function normalized.

Implications:

  • E-CPR is a viable rescue therapy for refractory cardiac arrest in pediatric patients with complex congenital heart disease.
  • Early initiation of E-CPR can improve outcomes in severe post-cardiac surgery complications.
  • Successful E-CPR may facilitate recovery of myocardial function in pediatric ALCAPA patients.