Upper-Body Extracorporeal Membrane Oxygenation as a Strategy in Decompensated Pulmonary Arterial Hypertension

PVRI Member Authors: Berman Rosenzweig


Pulmonary arterial hypertension (PAH) is a disease with significant morbidity and mortality, particularly during an acute decompensation. We describe a single-center experience of three patients with severe Group 1 PAH, refractory to targeted medical therapy, in which an extubated, nonsedated, extracorporeal membrane oxygenation (ECMO) strategy with an upper-body configuration was used as a bridge to recovery or lung transplantation. All three patients were extubated within 24 hours of ECMO initiation. Two patients were successfully bridged to lung transplantation, and the other patient was optimized on targeted PAH therapy with subsequent recovery from an acute decompensation. The upper-body ECMO configuration allowed for daily physical therapy, including one patient, who would otherwise have been unsuitable for transplantation, ambulating over 850 meters daily. This series demonstrates the feasibility of using ECMO to bridge PAH patients to recovery or transplantation while avoiding the complications of immobility and invasive mechanical ventilation.

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Experimental Organ and Tissue Transplantation and Grafting
Thoracic Surgery and Transplantation


Darryl C. Abrams, Daniel Brodie, Erika B. Rosenzweig, Kristin M. Burkart, Cara L. Agerstrand, Matthew D. Bacchetta

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Pulmonary Circulation Vol 3: No 2 cover image

June 2013

Pulmonary Circulation Vol 3: No 2

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