TYK229

Functional or structural cardiac diseases that may make VA ECMO less effective include:

a) Aortic insufficiency

b) ASD

c) Pericardial effusion

d) A and C

e) All of the above

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Answer

Answer a. Aortic insufficiency will obligate higher pump flows due to loss of partial aortic cannula flow back into the LV; depending on its severity, aortic insufficiency may be a contraindication to ECMO. An ASD should not cause any problem; an atrial connection may help unload the LV and may be created by balloon septostomy in select patients (see above). A pericardial effusion should also not cause functional problems, but progression to tamponade physiology and compression of the RA may limit venous drainage into the pump and requires urgent drainage.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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