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ECMO in Single Ventricle Heart Disease

  • Cardiology/CT Surgery (K Gist, Section Editor)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of review

Cardiac extracorporeal membrane oxygenation (ECMO) for single ventricle heart disease is a complex intervention applied to a heterogeneous population of children. In this review, we describe the variable single ventricle populations who may be supported with ECMO and highlight recent literature regarding outcomes, trends, and evolving strategies.

Recent findings

In the last decade, there has been a significant increase in the international volume of single ventricle cardiac ECMO, with an overall trend towards improved survival. Single ventricle ECMO has now been accepted as a viable modality in most international centers, with an overall survival approximating 45% in the modern era. Single ventricle cardiac disease, with or without the requirement for ECMO, has an important impact upon long-term health-related quality of life outcomes.

Summary

While survival is slightly lower for single ventricle ECMO than in children with biventricular physiology, the need for ECMO identifies a subset of single ventricle patients who are at increased risk for interstage mortality, adverse neurodevelopmental outcomes, and the early onset of advanced heart failure symptoms. Care for survivors after ECMO requires increased surveillance and risk assessment prior to future intervention.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, VIC, Australia

    Bennett Sheridan MBBS BMedSci FRACP FCICM, Warwick Butt MBBS FRACP FCICM FELSO & Graeme MacLaren MBBS MSc FCICM FELSO

  2. Clinical Sciences Theme, Murdoch Children’s Research Institute, Parkville, VIC, Australia

    Bennett Sheridan MBBS BMedSci FRACP FCICM & Warwick Butt MBBS FRACP FCICM FELSO

  3. Pediatric Intensive Care Unit, The Royal Children’s Hospital, Parkville, VIC, Australia

    Bennett Sheridan MBBS BMedSci FRACP FCICM, Warwick Butt MBBS FRACP FCICM FELSO & Graeme MacLaren MBBS MSc FCICM FELSO

  4. Department of Cardiology, The Royal Children’s Hospital, Parkville, VIC, Australia

    Bennett Sheridan MBBS BMedSci FRACP FCICM

  5. Cardiothoracic ICU, National University Health System, Singapore, Singapore

    Graeme MacLaren MBBS MSc FCICM FELSO

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  1. Bennett Sheridan MBBS BMedSci FRACP FCICM
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Correspondence to Graeme MacLaren MBBS MSc FCICM FELSO.

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Bennett Sheridan, Warwick Butt, and Graeme MacLaren declare no conflict of interest.

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Sheridan, B., Butt, W. & MacLaren, G. ECMO in Single Ventricle Heart Disease. Curr Treat Options Peds 5, 356–367 (2019). https://doi.org/10.1007/s40746-019-00173-4

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