ECMO can be a reliable bridge to secondary definitive surgery in patients with cardiogenic shock due to recurrent postinfarction ventricular septal defect.
May support ECMO bridging in recurrent PI-VSD shock; single-case data leaves open need for prospective validation.
A recurrent shunt after a postinfarction ventricular septal defect (PI-VSD) repair is common. We treated a case of cardiogenic shock caused by a large recurrent shunt after the patch repair of an apical PI-VSD with percutaneous extracorporeal membrane oxygenation (ECMO) for 4 days until a secondary definite repair. This suggests that percutaneous ECMO support is reliable before and after secondary definitive surgery in recurrent PI-VSD and may imply using a delayed surgical strategy with ECMO support to restore hemodynamic stability and avoid primary surgery on freshly fragile infarcted myocardium.
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Tsai et al. (2011) studied this question.
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