CASE REPORT
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 253-256

Fatal pulmonary hemorrhage due to severe mitral regurgitation during venoarterial extracorporeal membrane oxygenation


1 Department of Anesthesiology and Critical Care Medicine, University of New Mexico, Albuquerque, New Mexico
2 Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
3 Department of Anesthesiology, University of California San Diego, San Diego, California, USA

Correspondence Address:
Dr. Neal S Gerstein
Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine – MSC - 10 6000; Albuquerque, NM - 87106
New Mexico
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_773_19

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Pulmonary hemorrhage (PH) during venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been primarily reported in pediatric patients. We report a case of fatal PH during VA-ECMO for cardiogenic shock after myocardial infarction (MI). PH, in this case, was secondary to a triad of aortic insufficiency, left ventricle distension, and severe laminar mitral regurgitation. This case scenario, previously unreported in adults, illustrates the need for the echocardiographic assessment of left-sided heart valves prior to VA-ECMO initiation after MI as well as management considerations for massive PH in this context.


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