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Radiographic appearance of extracorporeal membrane oxygenations versus left ventricular assist device

Published online by Cambridge University Press:  20 May 2021

Phillip M Mackie ,
Giles J Peek Open the ORCID record for Giles J Peek [Opens in a new window] ,
Jeffrey P Jacobs Open the ORCID record for Jeffrey P Jacobs [Opens in a new window]  and
Mark S Bleiweis
Phillip M Mackie
Affiliation:
Congenital Heart Center, University of Florida, Gainesville, FL, USA
Giles J Peek
Affiliation:
Congenital Heart Center, University of Florida, Gainesville, FL, USA
Jeffrey P Jacobs
Affiliation:
Congenital Heart Center, University of Florida, Gainesville, FL, USA
Mark S Bleiweis*
Affiliation:
Congenital Heart Center, University of Florida, Gainesville, FL, USA
*
Author for correspondence: Mark S. Bleiweis, Congenital Heart Center, Division of Cardiovascular Surgery, Department of Surgery, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32608, USA. E-mail: bleiweis@ufl.edu
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Abstract

Chest radiography compares left ventricular decompression in the same patient supported with extracorporeal membrane oxygenation with atrial septal fenestration and subsequently supported with left ventricular assist device with apical cannulation.

Keywords

Extracorporeal membrane oxygenationECMOventricular assist deviceVADcongenital heart disease

Information

Type
Images in Congenital Cardiac Disease
Information
Cardiology in the Young , Volume 31 , Issue 5 , May 2021 , pp. 831 - 832
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

A 5-year-old girl with a previously undiagnosed anomalous aortic origin of the left coronary artery presented with shortness of breath and experienced a myocardial infarction associated with cardiac arrest. She was resuscitated with extracorporeal cardiopulmonary resuscitation, with institution of femoral extracorporeal membrane oxygenation, followed by transcatheter creation of an atrial septal defect and placement of an atrial stent to decompress the left atrium. She subsequently underwent unroofing of the anomalous coronary artery and placement of a Berlin Heart left ventricular assist device (Berlin EXCOR [Berlin Heart, Inc., Berlin, Germany]). The child is currently 2 weeks status post coronary unroofing and insertion of left ventricular assist device and is stable on mechanical support awaiting either ventricular recovery or cardiac transplantation.

Images of chest radiography compares left ventricular decompression in the same patient supported with extracorporeal membrane oxygenation with atrial septal fenestration (Fig 1) and subsequently supported with left ventricular assist device with apical cannulation (Fig 2). Radiographic images document that direct cannulation of the left ventricle with a left ventricular assist device notably decompressed the left ventricle in comparison to extracorporeal membrane oxygenation with atrial septal fenestration.

Figure 1.

An anterior–posterior chest radiograph of a 5-year-old girl with an atrial stent on femoral veno-arterial extracorporeal membrane oxygenation.

Figure 2.

An anterior–posterior chest radiograph of the same patient status post-direct cannulation of the left ventricle with a Berlin left ventricular assist device.

Acknowledgements

The authors wish to thank our colleagues from interventional cardiology, James C. Fudge, MD and Himesh V Vyas, MD, for their assistance in caring for this patient and for their clinical support by fenestrating the atrial septum and placing the atrial stent promptly after the initiation of extracorporeal membrane oxygenation.

Financial support

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Conflicts of interest

None.

Figure 0

Figure 1. An anterior–posterior chest radiograph of a 5-year-old girl with an atrial stent on femoral veno-arterial extracorporeal membrane oxygenation.

Figure 1

Figure 2. An anterior–posterior chest radiograph of the same patient status post-direct cannulation of the left ventricle with a Berlin left ventricular assist device.