Endovascular repair as a rescue strategy to restoring the extracorporeal membrane oxygenation flow
Filip Depta1 
, Dušan Rybár1, Ivan Kopolovets2, Matej Moščovič3, Tomáš Grendel1
1Department of Critical Care, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia
2Department of Vascular Surgery, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia
3Department of Cardiology, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia
Keywords: Common iliac artery, endovascular repair, extracorporeal membrane oxygenation, ventricular septal defect
Abstract
Ventricular septal defect (VSD) is a known complication after myocardial infarction associated with high mortality. Extracorporeal membrane oxygenation (ECMO) is being successfully used in patients with VSD as a bridge to definitive surgical repair. Although often the only possibility to stabilize hemodynamics and oxygenation, ECMO has many potential complications, carrying significant morbidity and mortality. Here, the patient presented with a postinfarct VSD on peripheral venoarterial ECMO who developed a dissection of the common iliac artery (CIA) on the 5th day after ECMO implantation. As a result, a sudden drop in ECMO flow has become evident along with high pressures in the arterial cannula. After a definitive diagnosis of a CIA lesion obstructing the blood flow was made, trans ECMO endovascular repair of CIA was performed. Four days after endovascular repair, we encountered the same problem of decreased blood flow associated with stent kinking and were approached with another endovascular repair to re establishing full ECMO flow.
How to cite this article: Depta F, Rybár D, Kopolovets I, Moščovič M, Grendel T. Endovascular repair as a rescue strategy to restoring the extracorporeal membrane oxygenation flow. Turk J Emerg Med 2023;23:127-30.
Independent Ethics Committee of East Slovak Institute for Cardiovascular diseases approved the publication (No. A1062022) on June 23, 2022.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
FD: Conceptualization, Resources, Visualization, Writing ‑ original draft, Writing, Reviewing and Editing TG, DR, MM, IK: Resources, Writing, Reviewing TG, DR, MM, IK: Writing – Extensive Review and Editing.
None Declared.
None.