Intensive Care Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Perfusion. 2021 Apr;36(3):315-317. doi: 10.1177/0267659120938530. Epub 2020 Jul 10.
A case report of successful application of peripheral veno-arterial extracorporeal membrane oxygenation in a patient with chronic type B aortic dissection and myocardial stunning to bridge to recovery was presented. Good outcomes from the application of peripheral veno-arterial extracorporeal membrane oxygenation in aortic dissection have rarely been reported, and the considerations of starting veno-arterial extracorporeal membrane oxygenation in this situation were seldom discussed. The orthodox that peripheral veno-arterial extracorporeal membrane oxygenation is an absolute contraindication for initiation of peripheral veno-arterial extracorporeal membrane oxygenation should be challenged. With proper planning and real-time transesophageal echocardiography-guided cannulation, peripheral veno-arterial extracorporeal membrane oxygenation is possibly beneficial. The considerations and echocardiography-guided techniques would be discussed in this report.
本文报告了一例慢性 B 型主动脉夹层伴心肌顿抑患者成功应用外周动静脉体外膜肺氧合（VA-ECMO）桥接恢复的病例。VA-ECMO 在主动脉夹层中的应用鲜有良好结局的报道，在此情况下启动 VA-ECMO 的考虑因素也很少讨论。外周 VA-ECMO 被认为是启动 VA-ECMO 的绝对禁忌证，这一传统观点值得挑战。通过适当的规划和实时经食管超声心动图引导下的置管，VA-ECMO 可能是有益的。本文将讨论相关的考虑因素和经食管超声心动图引导技术。
