Key result
VA-ECMO combined with blood purification successfully bridges ischemic VSD to surgical closure.
Why the study?
Postinfarction ventricular septal defect remains a serious and often lethal complication with debate over optimal timing of surgical repair and bridging strategies.
Case Report (n=1)
VA-ECMO combined with extracorporeal blood purification may serve as a viable bridge to surgical closure for patients with postinfarction VSD and cardiogenic shock.
May support bridge strategy in refractory postinfarction VSD shock; hypothesis-generating and requires prospective validation before adoption.
Even in the modern era of percutaneous coronary intervention, postinfarction ventricular septal defect (VSD) remains a serious and often lethal complication. Whether or not immediate surgical repair or delaying surgery a few days aided by intra-aortic counterpulsation provides the optimal strategy remains a matter of debate. An interdisciplinary approach of intensivists and cardiac surgeons in this setting is mandatory. We report the use of veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy (CytoSorb®) as bridging to surgical closure in a patient with an ischemic VSD leading to protracted cardiogenic shock after posterior myocardial infarction.
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Marek et al. (2017) conducted a case report in Ischemic ventricular septal defect leading to protracted cardiogenic shock (n=1). Veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy (CytoSorb®) was evaluated on Bridging to surgical closure. Veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy were used as bridging to surgical closure in a patient with an ischemic VSD.
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