ABSTRACT
OBJECTIVES: Left ventricular distention can be recognized during the use of venoarterial extracorporeal membrane oxygenation as a key complication. Left ventricular decompression may decrease pulmonary pressure, minimize ventricular distention, and allow myocardial recovery. MATERIALS AND METHODS: We applied venoarterial extracorporeal membrane oxygenation to 4 patients while on a wait list for cardiac transplant. RESULTS: Two patients with severe heart failure developed high end-diastolic pressures leading to left ventricular distention. We used atrial venting methods to decrease the pressure. CONCLUSIONS: Here, we discussed the strategies to manage ventricular distention by conservative, interventional, and surgical means.
Subject(s)
Decompression, Surgical/methods , Extracorporeal Membrane Oxygenation/methods , Heart Failure/therapy , Heart Transplantation , Ventricular Function, Left , Ventricular Pressure , Child , Female , Heart Failure/diagnosis , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Male , Middle Aged , Recovery of Function , Severity of Illness Index , Time Factors , Treatment Outcome , Waiting ListsABSTRACT
We report a very rare case of a 55-year-old man with chest wall metastatic tumor caused by seeding of hepatocellular carcinoma after percutaneous radiofrequency ablation (RFA) for hepatic tumor 42 months after the initial operation. The patient was managed with aggressive full-thickness chest wall resection and reconstruction with a Prolene (Ethicon, Somerville, NJ) and methyl methacrylate sandwich graft and subsequent musculocutaneous free-flap transposition.
