Atrial septostomy for left atrial decompression during extracorporeal membrane oxygenation by Inoue balloon catheter

Yen Nien Lin, Yin Huei Chen, Huang Joe Wang, Jui Sung Hung, Kuan Cheng Chang, Ping Han Lo*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

31 Scopus citations

Abstract

Background: Refractory pulmonary edema is an infrequent but serious complication in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) for myocardial failure. Left atrial (LA) decompression in this setting is important. Although a few methods have been reported, the experience is mostly limited to children. We aimed to evaluate the feasibility of Inoue balloon catheter in percutaneous trans-septal LA decompression in adult cardiogenic patients. Methods and Results: We retrospectively analyzed 16 procedures of trans-septal LA decompression by Inoue balloon catheter in 15 VA-ECMO patients (aged 22-65 years, 6 men) with refractory pulmonary edema from May 2012 to December 2014. Mean left ventricular ejection fraction was 15%. The cause of cardiogenic shock included 7 cases of ischemic heart disease, 1 of dilated cardiomyopathy, 5 of myocarditis, and 2 of fatal ventricular arrhythmia. The procedures were performed 4.3 days after ECMO. Inoue balloon size was 24-27 mm. LA septostomy were successfully created in 14 patients. Procedure time on average was 36.8 min (range, 15-85 min). There were no procedure-related complications. Radiography on the next day showed rapid resolution of pulmonary edema. Conclusions: Trans-septal LA decompression by Inoue balloon catheter is a feasible alternative method for adult patients with refractory pulmonary edema under ECMO.

Original languageEnglish
Pages (from-to)1419-1423
Number of pages5
JournalCirculation Journal
Volume81
Issue number10
DOIs
StatePublished - 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017, Japanese Circulation Society. All rights reserved.

Keywords

  • Atrial septostomy
  • Extracorporeal membrane oxygenation
  • Left atrial decompression
  • Pulmonary edema
  • Trans-septal Catheterization

Fingerprint

Dive into the research topics of 'Atrial septostomy for left atrial decompression during extracorporeal membrane oxygenation by Inoue balloon catheter'. Together they form a unique fingerprint.

Cite this