ISSN 2149-2263 | E-ISSN 2149-2271
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Cardiac catheterization procedures in pediatric patients undergoing extracorporeal membrane oxygenation cardiac catheterization, ECMO [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(6): 425-430 | DOI: 10.14744/AnatolJCardiol.2017.7927

Cardiac catheterization procedures in pediatric patients undergoing extracorporeal membrane oxygenation cardiac catheterization, ECMO

Alper Güzeltaş1, Taner Kasar1, İbrahim Cansaran Tanıdır1, Erkut Öztürk1, Okan Yıldız2, Sertaç Haydin2
1Department of Pediatric Cardiology, İstanbul Sağlık Bilimleri University, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, İstanbul-Turkey
2Department of Pediatric Cardiovascular Surgery, İstanbul Sağlık Bilimleri University, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, İstanbul-Turkey

Objective: Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention for pediatric patients with respiratory and/or cardiovascular failure. In this study, we evaluated the cardiac catheterization results of pediatric patients on ECMO support.
Methods: Between January 2012 and October 2016, 98 patients (5.2% of all surgery patients) needed ECMO support during perioperative cardiac surgery. We retrospectively reviewed the clinical data of 16 patients who underwent cardiac catheterization under ECMO support.
Results: The median age at catheterization was 6.5 months (range, 3.3–60 months ), and the median weight was 6.0 kg (range, 3.7–16 kg ). Eight of the catheterizations were diagnostic, and the remaining eight were interventional. Five out of these eight patients underwent surgical palliation after diagnostic catheterization. Right pulmonary artery (RPA) stenting, right ventricular outflow tract (RVOT) stenting, combined left pulmonary artery (LPA) and RVOT stenting, combined LPA and modified Blalock-Taussig shunt stenting, bilateral pulmonary artery balloon angioplasty, and bilateral pulmonary artery stenting were each performed once, whereas LPA stenting was performed in two different patients. In one patient undergoing RVOT stenting, a complete atrioventricular block developed, resulting in hypotension; however, this was overcome with an ECMO flow increase. In another patient, the ECMO tubing disconnected from the arterial line. Minor vascular complications were seen in three patients. Twelve patients (75%) were successfully weaned from ECMO after the procedure and ten (63%) were discharged.
Conclusion: Diagnostic and interventional cardiac catheterization can be safely and effectively performed in patients on ECMO. If the patient cannot be weaned from ECMO support, clinicians should consider performing an early angiogram either to treat or clarify the underlying problem.

Keywords: cardiac catheterization, child, infant, extracorporeal membrane oxygenation, ECMO

Alper Güzeltaş, Taner Kasar, İbrahim Cansaran Tanıdır, Erkut Öztürk, Okan Yıldız, Sertaç Haydin. Cardiac catheterization procedures in pediatric patients undergoing extracorporeal membrane oxygenation cardiac catheterization, ECMO. Anatol J Cardiol. 2017; 18(6): 425-430

Corresponding Author: Alper Güzeltaş, Türkiye
Manuscript Language: English


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