The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)

Aim: to evaluate the effect of extracorporeal membrane oxygenation (ECMO) as a life support in the treatment of a patient with refractory ventricular tachycardia developed after Fontan procedure. Patient and treatment. A 4-year-old child developed refractory ventricular tachycardia (up to 250 bpm) a...

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Main Authors: Olga S. Anikina, Ilya A. Soynov, Ilya A. Velyukhanov, Olga A. Suzdalova, Yuri Yu. Kulyabin, Stanislav A. Sergeev, Alexey N. Arkhipov, Igor A. Kornilov
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2024-10-01
Series:Общая реаниматология
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Online Access:https://www.reanimatology.com/rmt/article/view/2347
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author Olga S. Anikina
Ilya A. Soynov
Ilya A. Velyukhanov
Olga A. Suzdalova
Yuri Yu. Kulyabin
Stanislav A. Sergeev
Alexey N. Arkhipov
Igor A. Kornilov
author_facet Olga S. Anikina
Ilya A. Soynov
Ilya A. Velyukhanov
Olga A. Suzdalova
Yuri Yu. Kulyabin
Stanislav A. Sergeev
Alexey N. Arkhipov
Igor A. Kornilov
author_sort Olga S. Anikina
collection DOAJ
description Aim: to evaluate the effect of extracorporeal membrane oxygenation (ECMO) as a life support in the treatment of a patient with refractory ventricular tachycardia developed after Fontan procedure. Patient and treatment. A 4-year-old child developed refractory ventricular tachycardia (up to 250 bpm) and hemodynamic depression 18 hours after the Fontan procedure. After the failure of cardiopulmonary resuscitation and antiarrhythmic therapy, resternotomy with central venoarterial (VA) ECMO support was performed, followed by diagnostic angiocardiography. Contrast-enhanced cavopulmonary angiography revealed stenosis of the left pulmonary artery, which was treated with balloon angioplasty and stenting.Results. Ventricular tachycardia resolved and sinus rhythm was restored within 24 hours after left pulmonary artery stenting, supported by continuous ECMO and antiarrhythmic therapy. On day 3, transthoracic echocardiography showed good single ventricle contractility after a trial weaning from ECMO. As a result, the ECMO support was removed and the sternum sutured. The patient was discharged from the hospital on day 47 in stable condition.Conclusion. The prompt initiation of VA ECMO support in a 4-year old patient with refractory ventricular tachycardia post-Fontan procedure along with the complex management of post-procedural residual tachycardia using a combination of antiarrhythmic agents helped restoring sinus rhythm and could contribute to preventing neurological complications.
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publishDate 2024-10-01
publisher Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
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spelling doaj-art-710cc1407bdd4de3a497bc6cc196ba8d2025-08-20T03:18:33ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102024-10-01205778010.15360/1813-9779-2024-5-77-801965The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)Olga S. Anikina0Ilya A. Soynov1Ilya A. Velyukhanov2Olga A. Suzdalova3Yuri Yu. Kulyabin4Stanislav A. Sergeev5Alexey N. Arkhipov6Igor A. Kornilov7E. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaE. N. Meshalkin National Medical Research Center, Ministry of Health of RussiaMilton S. Hershey Medical Center, Penn State University College of MedicineAim: to evaluate the effect of extracorporeal membrane oxygenation (ECMO) as a life support in the treatment of a patient with refractory ventricular tachycardia developed after Fontan procedure. Patient and treatment. A 4-year-old child developed refractory ventricular tachycardia (up to 250 bpm) and hemodynamic depression 18 hours after the Fontan procedure. After the failure of cardiopulmonary resuscitation and antiarrhythmic therapy, resternotomy with central venoarterial (VA) ECMO support was performed, followed by diagnostic angiocardiography. Contrast-enhanced cavopulmonary angiography revealed stenosis of the left pulmonary artery, which was treated with balloon angioplasty and stenting.Results. Ventricular tachycardia resolved and sinus rhythm was restored within 24 hours after left pulmonary artery stenting, supported by continuous ECMO and antiarrhythmic therapy. On day 3, transthoracic echocardiography showed good single ventricle contractility after a trial weaning from ECMO. As a result, the ECMO support was removed and the sternum sutured. The patient was discharged from the hospital on day 47 in stable condition.Conclusion. The prompt initiation of VA ECMO support in a 4-year old patient with refractory ventricular tachycardia post-Fontan procedure along with the complex management of post-procedural residual tachycardia using a combination of antiarrhythmic agents helped restoring sinus rhythm and could contribute to preventing neurological complications.https://www.reanimatology.com/rmt/article/view/2347ecmorefractory ventricular tachycardia in childrenfontan procedure
spellingShingle Olga S. Anikina
Ilya A. Soynov
Ilya A. Velyukhanov
Olga A. Suzdalova
Yuri Yu. Kulyabin
Stanislav A. Sergeev
Alexey N. Arkhipov
Igor A. Kornilov
The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
Общая реаниматология
ecmo
refractory ventricular tachycardia in children
fontan procedure
title The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
title_full The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
title_fullStr The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
title_full_unstemmed The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
title_short The Effect of Extracorporeal Membrane Oxygenation in the Management of Refractory Ventricular Tachycardia Developed after Fontan Procedure (Case Report)
title_sort effect of extracorporeal membrane oxygenation in the management of refractory ventricular tachycardia developed after fontan procedure case report
topic ecmo
refractory ventricular tachycardia in children
fontan procedure
url https://www.reanimatology.com/rmt/article/view/2347
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