Use of Extracorporeal Membrane Oxygenation for Major Cardiopulmonary Resections.


Journal

The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387

Informations de publication

Date de publication:
04 2021
Historique:
pubmed: 9 4 2020
medline: 20 5 2021
entrez: 9 4 2020
Statut: ppublish

Résumé

In thoracic surgery, utilization of extracorporeal membrane oxygenation (ECMO) is mainly established for patients undergoing lung transplantation. The aim of our study was to summarize our single-center experience with intraoperative use of veno-venous- or veno-arterial-ECMO in patients undergoing complex lung surgery involving the main carina, or the left atrium or the descending aorta. A total of 24 patients underwent combined complex lung, carinal, aortal, or left atrial resections. In cases of carinal resection, percutaneous veno-venous, jugular-femoral cannulation was considered suitable. For combined resection of lung and descending aorta, a percutaneous femoral veno-arterial cannulation was used. In cases of extended left atrial resection, a percutaneous jugular-femoral veno-venous-arterial cannulation was favored. Procedures were divided into three groups: carinal resections and reconstruction ( The present study shows that intraoperative use of ECMO for extended carinal, aortic, or atrial resections is feasible with minimal intraoperative complications allowing surgeons increased operating-field safety. Perioperative mortality is high, but this is rather an attribute of local extended disease and patient comorbidities.

Sections du résumé

BACKGROUND
In thoracic surgery, utilization of extracorporeal membrane oxygenation (ECMO) is mainly established for patients undergoing lung transplantation. The aim of our study was to summarize our single-center experience with intraoperative use of veno-venous- or veno-arterial-ECMO in patients undergoing complex lung surgery involving the main carina, or the left atrium or the descending aorta.
METHODS
A total of 24 patients underwent combined complex lung, carinal, aortal, or left atrial resections. In cases of carinal resection, percutaneous veno-venous, jugular-femoral cannulation was considered suitable. For combined resection of lung and descending aorta, a percutaneous femoral veno-arterial cannulation was used. In cases of extended left atrial resection, a percutaneous jugular-femoral veno-venous-arterial cannulation was favored.
RESULTS
Procedures were divided into three groups: carinal resections and reconstruction (
CONCLUSION
The present study shows that intraoperative use of ECMO for extended carinal, aortic, or atrial resections is feasible with minimal intraoperative complications allowing surgeons increased operating-field safety. Perioperative mortality is high, but this is rather an attribute of local extended disease and patient comorbidities.

Identifiants

pubmed: 32268398
doi: 10.1055/s-0040-1708486
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

231-239

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None.

Auteurs

Aris Koryllos (A)

Department of Thoracic Surgery, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Alberto Lopez-Pastorini (A)

Department of Thoracic Surgery, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Thomas Galetin (T)

Department of Thoracic Surgery, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Jerome Defosse (J)

Department of Anaesthesiology and Intensive Care Medicine, Kliniken der Stadt Köln gGmbH, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Stephan Strassmann (S)

ARDS and ECMO Centre, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Christian Karagiannidis (C)

ARDS and ECMO Centre, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

Erich Stoelben (E)

Department of Thoracic Surgery, Kliniken der Stadt Köln gGmbH, Lung Clinic, University of Witten Herdecke, Cologne, Nordrhein-Westfalen, Germany.

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