Inferior Vena Cava Obstruction Complicating Remote Venovenous Extracorporeal Membrane Oxygenation Bridge to Lung Transplantation

Chest. 2022 Jul;162(1):e5-e8. doi: 10.1016/j.chest.2022.01.062.

Abstract

Extracorporeal membrane oxygenation (ECMO) increasingly is being used to support acute respiratory failure and for bridging to lung transplantation. Bleeding and thrombosis are common complications in the acute setting, but the literature describing long-term ECMO complications is limited, and no previous reports have been made of delayed central venous strictures resulting from remote ECMO bridging. Herein, we describe a patient who demonstrated complete inferior vena cava obstruction resulting from venovenous ECMO bridge to lung transplantation 5 years previously. The severe stricture and secondary thrombosis were managed with inferior vena cava angioplasty, stenting, thrombectomy, and thrombolysis, leading to clinical improvement. This case highlights the need for awareness and monitoring for long-term vascular complications in a growing population of patients who have received ECMO support.

Keywords: ECMO; IVC stenosis; bridge to transplant; thrombosis; vascular complication.

Publication types

  • Case Reports

MeSH terms

  • Constriction, Pathologic
  • Extracorporeal Membrane Oxygenation* / methods
  • Humans
  • Lung Transplantation* / adverse effects
  • Respiratory Distress Syndrome*
  • Thrombosis*
  • Vena Cava, Inferior / diagnostic imaging