Key result
Elective extracorporeal membrane oxygenation enabled safe general anesthesia and successful transcatheter aortic valve replacement in a patient with severe aortic stenosis and acute decompensated heart failure.
Why the study?
Does elective ECMO use during TAVR under general anesthesia prevent hemodynamic collapse in a patient with severe AS and acute decompensated heart failure?
Case Report (n=1)
No
Does elective ECMO use during TAVR under general anesthesia prevent hemodynamic collapse in a patient with severe AS and acute decompensated heart failure?
Elective ECMO can be a useful strategy to prevent hemodynamic collapse during TAVR under general anesthesia in patients with severe AS and acute decompensated heart failure.
We managed general anesthesia for transcatheter aortic valve replacement (TAVR) under elective extracorporeal membrane oxygenation (ECMO) in a patient with aortic valve stenosis (AS) complicated with acute decompensated heart failure. The patient was an 87-year-old woman with acute heart failure due to severe AS who had been hospitalized. However, her low cardiac output did not improve, and weaned her off catecholamines was difficult, so semi-urgent TAVR was performed. Due to her acute decompensated heart failure complicated by low-left ventricular function, we decided electively to use ECMO for transfemoral TAVR to prevent hemodynamic collapse during induction of anesthesia and surgery, enabling the safe perioperative management of this patient under general anesthesia.
No takes yet. Share an insight, caveat, or question.
Okada et al. (2019) conducted a case report in Aortic Valve Stenosis with acute decompensated heart failure (n=1). Transcatheter Aortic Valve Replacement (TAVR) under elective Extracorporeal Membrane Oxygenation (ECMO) was evaluated on Successful procedure and recovery. Elective extracorporeal membrane oxygenation enabled safe general anesthesia and successful transcatheter aortic valve replacement in a patient with severe aortic stenosis and acute decompensated heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: