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.