TYK226
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The indications for Balloon Atrial Septostomy during VA ECMO include:
a) High SvO2
b) Left atrial distension and pulmonary edema
c) Pulmonary hypertension with right heart failure
d) SpO2 less than 85%, despite maximal support
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Answer
Answer b. Indications for BAS include severe left heart dysfunction and left atrial distension, causing pulmonary venous hypertension and pulmonary edema. BAS would not be helpful for pulmonary hypertension on ECMO (as the right heart is decompressed by the ECMO circuit) and BAS would increase SvO2 due to left-toright shunting.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.