Background Extracorporeal membrane oxygenation(ECMO)support on D-transposition of the great arteries(D-TGA)carries formidable challenges.Methods A retrospective study was performed on pediatric patients with D-TGA sup...Background Extracorporeal membrane oxygenation(ECMO)support on D-transposition of the great arteries(D-TGA)carries formidable challenges.Methods A retrospective study was performed on pediatric patients with D-TGA supported by ECMO from July 2007 to December 2019.This study summarized the clinical experience of ECMO support in pediatric patients with D-TGA preoperative,intraoperative,and postoperative.Results Overall,16 children with D-TGA received ECMO support during this period.Two(2 of 16)were supported before cardiac surgery,3(3 of 16)were supported postoperatively in the intensive care unit,and 11(11 of 16)failed to wean off cardiopulmonary bypass.Two cases of preoperative ECMO support for patients with D-TGA with an intact ventricular septum and restrictive atrial septum due to severe hypoxemia died.In this study,D-TGA with coronary artery malformation and other complicated deformities died(8 of 14),whereas uncomplicated D-TGA without coronary artery malformation all survived(6 of 14).The wean-off rate of ECMO patients supported in D-TGA was 62.5%(10 of 16),while the 30-day survival rate was 44%(7 of 16).Conclusion Although a promising ECMO weaning rate was obtained,30-day survival of this population was frustrating,mainly attributed to the original anatomy of coronary arteries and the concomitant deformities.展开更多
基金This study was approved by Zhejiang University School of Medicine Children’s Hospital Committee on Clinical Investigation(No.2021-IRB-051).
文摘Background Extracorporeal membrane oxygenation(ECMO)support on D-transposition of the great arteries(D-TGA)carries formidable challenges.Methods A retrospective study was performed on pediatric patients with D-TGA supported by ECMO from July 2007 to December 2019.This study summarized the clinical experience of ECMO support in pediatric patients with D-TGA preoperative,intraoperative,and postoperative.Results Overall,16 children with D-TGA received ECMO support during this period.Two(2 of 16)were supported before cardiac surgery,3(3 of 16)were supported postoperatively in the intensive care unit,and 11(11 of 16)failed to wean off cardiopulmonary bypass.Two cases of preoperative ECMO support for patients with D-TGA with an intact ventricular septum and restrictive atrial septum due to severe hypoxemia died.In this study,D-TGA with coronary artery malformation and other complicated deformities died(8 of 14),whereas uncomplicated D-TGA without coronary artery malformation all survived(6 of 14).The wean-off rate of ECMO patients supported in D-TGA was 62.5%(10 of 16),while the 30-day survival rate was 44%(7 of 16).Conclusion Although a promising ECMO weaning rate was obtained,30-day survival of this population was frustrating,mainly attributed to the original anatomy of coronary arteries and the concomitant deformities.
