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INTRODUCTION: Severe hypothermia is a life-threatening condition that often causes hemodynamic instability or cardiac arrest and carries a high risk of mortality. The use of VA-ECMO in this indication has greatly improved the prognosis of patients. CASE REPORT: We describe an incredible case involving the complete recovery of a 47-year-old man placed on VA-ECMO for cardiogenic shock and protracted ventricular fibrillation caused by hypothermia. The patient was discharged home in 20 days with no neurologic sequelae. CLINICAL DISCUSSION: Extracorporeal life support (ECLS) with cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) has been recommended as the gold standard for the treatment of severe hypothermia due to its rapid availability and the possibility of prolonged support. Our case demonstrates the effectiveness of ECMO in treating patients with hypothermic cardiogenic shock. At the same time, nutritional support and rehabilitation therapy play an integral role in the whole treatment process. Therefore, it is recommended that such patients be managed by an experienced cardiac team that can evaluate the patient's condition in multiple aspects. CONCLUSION: ECMO may be an effective treatment for hypothermia-induced cardiogenic shock, but further research is needed on the effectiveness of this method of treatment.
RESUMO
Large pulmonary artery aneurysm with severe pulmonary valve regurgitation due to the quadricuspid pulmonary valve (Type F) was found in a 54-year-old woman with fatigue and dyspnea on exertion, and in New York Heart Association (NYHA) functional class III. The annulus plication and bicuspidization technique were successfully used for the pulmonary valvular reconstruction. Then, the main pulmonary artery was replaced with Dacron graft and the left pulmonary arterioplasty was performed. Postoperative echocardiography confirmed a satisfactory motion of the reconstructed pulmonary valve with trivial regurgitation and no stenosis.
