Effects of preoperative veno-venous extracorporeal membrane oxygenation management and left atrial pressure reduction via balloon atrial septostomy on respiratory system compliance in a neonate with transposition of the great arteries with intact ventricular septum
Background: Transposition of the great arteries with intact ventricular septum causes severe hypoxia immediately after birth. Balloon atrial septostomy is often required for oxygenation improvement, and severe cases may require veno-venous extracorporeal membrane oxygenation (VV-ECMO). This case rep...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007125000267 |
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| Summary: | Background: Transposition of the great arteries with intact ventricular septum causes severe hypoxia immediately after birth. Balloon atrial septostomy is often required for oxygenation improvement, and severe cases may require veno-venous extracorporeal membrane oxygenation (VV-ECMO). This case report highlights the critical role of balloon atrial septostomy in improving respiratory system compliance and facilitating early ECMO discontinuation in a neonate with transposition of the great arteries. Case summary: A neonate with transposition of the great arteries experienced persistent hypoxia, hypotension, and lactic acidosis, prompting VV-ECMO on the first day of life. Echocardiography revealed a restrictive atrial septal defect, and balloon atrial septostomy was performed. This resulted in increased oxygen saturation, improved respiratory system compliance (from 0.19 to 0.43 mL/cmH2O/kg), and reduced left atrial pressure. ECMO was successfully withdrawn on day 2, which was later followed by a successful Jatene procedure. Conclusion: Balloon atrial septostomy can significantly improve oxygenation and respiratory system compliance in patients with transposition of the great arteries, enabling rapid VV-ECMO discontinuation and informing future congenital heart disease management. |
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| ISSN: | 2213-0071 |