Mechanical support for pulmonary veno-occlusive disease: combined atrial septostomy and venovenous extracorporeal membrane oxygenation

Semin Thorac Cardiovasc Surg. Autumn 2012;24(3):232-4. doi: 10.1053/j.semtcvs.2012.03.003.

Abstract

The use of atrial septostomy for refractory pulmonary hypertension and right ventricular failure results in an adequate left ventricular preload and improved cardiac output at the expense of a profound hypoxic shunt. Combined dual-lumen venovenous extracorporeal membrane oxygenation and atrial septostomy provides extracorporeal gas exchange of venous return before the directional right atrial to left atrial shunt, can be deployed percutaneously, and results in an ambulatory patient with stable hemodynamics.

MeSH terms

  • Atrial Septum / diagnostic imaging
  • Atrial Septum / physiopathology
  • Atrial Septum / surgery*
  • Cardiac Catheterization
  • Cardiac Surgical Procedures*
  • Echocardiography, Doppler, Color
  • Extracorporeal Membrane Oxygenation*
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / physiopathology
  • Hypertension, Pulmonary / therapy
  • Ostomy*
  • Pulmonary Circulation
  • Pulmonary Veno-Occlusive Disease / diagnosis
  • Pulmonary Veno-Occlusive Disease / physiopathology
  • Pulmonary Veno-Occlusive Disease / surgery
  • Pulmonary Veno-Occlusive Disease / therapy*
  • Treatment Outcome
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Dysfunction, Right / therapy
  • Ventricular Function, Left
  • Ventricular Function, Right