The journal of extra-corporeal technology · 2026
Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Wirth Camille, De Normandie Pierre, Hascoet Sebastien, Fadel Elie, Stephan François
Аннотация
BACKGROUND: Atrial septostomy has been successfully used in patients with pulmonary hypertension and in those supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) complicated by pulmonary congestion.
CASE DESCRIPTION: We report a patient on VA-ECMO for decompensated pulmonary hypertension who subsequently developed stress-induced cardiomyopathy and pulmonary congestion. An atrial septostomy was performed, which led to worsening respiratory status due to the creation of a right-to-left shunt, and hemodynamic deterioration resulting from increased left ventricular preload.
CONCLUSION: The implications of atrial septostomy should be carefully considered prior to decompression, as there may be situations, especially if right-sided pressures are less than left-sided pressures, where patients may still benefit.
CASE DESCRIPTION: We report a patient on VA-ECMO for decompensated pulmonary hypertension who subsequently developed stress-induced cardiomyopathy and pulmonary congestion. An atrial septostomy was performed, which led to worsening respiratory status due to the creation of a right-to-left shunt, and hemodynamic deterioration resulting from increased left ventricular preload.
CONCLUSION: The implications of atrial septostomy should be carefully considered prior to decompression, as there may be situations, especially if right-sided pressures are less than left-sided pressures, where patients may still benefit.