[Extracorporeal circulation with membrane oxygenation in high-risk coronary surgery]

The case of a patient operated for left main stem disease in which cardiopulmonary bypass (CPB) lasted 7 hours because of acute severe myocardial failure is reported. A satisfactory recovery of autonomous hemodynamic function was achieved. This case illustrates the technical progress which has been made in CPB: reduction of blood cell trauma in the bypass circuits, improved oxygenation reducing the disturbances of tissue perfusion usually associated with bubble oxygenators. The use of hypothermia in vasoplegic patients also contributes to the reduction in the incidence of complications. These improvements result in the optimal recovery of ischemic myocardial fibres and reduce the need for pharmacological support which is always difficult to manage and which is often associated with unwanted side effects.