TYK229
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Functional or structural cardiac diseases that may make VA ECMO less effective include:
a) Aortic insufficiency
b) ASD
c) Pericardial effusion
d) A and C
e) All of the above
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Answer
Answer a. Aortic insufficiency will obligate higher pump flows due to loss of partial aortic cannula flow back into the LV; depending on its severity, aortic insufficiency may be a contraindication to ECMO. An ASD should not cause any problem; an atrial connection may help unload the LV and may be created by balloon septostomy in select patients (see above). A pericardial effusion should also not cause functional problems, but progression to tamponade physiology and compression of the RA may limit venous drainage into the pump and requires urgent drainage.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.