Conclusion and results
The patient was successfully decannulated from VA-ECMO on day 3 of tertiary centre admission. Decannulation was complicated by right femoral artery embolus for which she underwent successful embolectomy. After transfer back to the referring centre, the patient was weaned from sedation and ventilatory requirements without incident. The patient was soon afterwards discharged from hospital with close psychiatric support in the community.
A bedside transthoracic echocardiogram (TTE) immediately following her cardiac arrest showed evidence of right ventricular volume and pressure overload. Agitated saline did not demonstrate any obvious intracardiac shunt. A subsequent TTE and transoesophaegeal echocardiogram (TOE) on day 2 of VA-ECMO demonstrated normal right ventricular size and function. A cardiac magnetic resonance scan performed 2 months following discharge confirmed sustained normal cardiac function with no evidence of cardiomyopathy.