Kristina KapussidiResearch clinical Center for Cardiac Surgery and Transplantology, Russia
Title: “Successful ecmo support for covid-19 induced severe ards in patient after lvad implantation”
Covid-19 has recently emerged as an aggravating factor in cardiovascular diseases. In most patients, it proceeds with a mild or moderate degree respiratory failure. However, in some cases, disease progression can lead to severe hypoxemia. In these cases, only extracorporeal membrane oxygenation (ECMO) is the method of choice to save the patient from death.
We present a case of successful use of ECMO to maintain lung function in a patient with severe lung injury with a previously implanted left ventricular assist device (LVAD).
The 22-year-old patient Zh.M. 6 months after LVAD implantation, acute respiratory distress syndrome and right ventricular failure developed due to Covid-19 infection. Data before ECMO inclusion: SpO2 – 79%, CVP - 240 mmHg, RR - 28, HR - 118, BP - 62/45 mmHg, systolic PAP – 42 mmHg. Percutaneous cannulation of the pulmonary artery was performed for blood outflow and for the inflow of the femoral vein . With the normalization of indicators: SpO2 - 98, CVP - 120 mm Hg, RR - 18, R-90, LAD-30, after 7 days of support, she was disconnected from ECMO, underwent a smooth recovery and was successfully discharged home.
Conclusions: 1. Patients after LVAD implantation may be at increased risk of mortality in cases of Covid-19 infection.
2. Timely use of extracorporeal membrane oxygenation with percutaneous cannulation of pulmonary artery outflow and femoral vein inflow can effectively maintain right ventricular function and lung ventilation, leading to full recovery.