Chapters authored
Cardiac Catheterisation and Intervention on ECMO
Cardiac catheterisation is an essential tool to evaluate patients who require ECMO support for severe haemodynamic impairment. In the first part of this chapter, we describe the equipment, teamwork, expertise, techniques and precautions that are necessary to carry out safe and effective cardiac catheterisation on ECMO. We have moved on from an early pioneering era to a stage where the multidisciplinary team approach has been worked out in detail, using operational procedures that deal with the technical challenges and minimise the risks of ECMO catheterisation and intervention. In the second part of the chapter, we explain in detail how cardiac catheterisation and intervention on ECMO contribute to the management of (1) post-operative congenital heart disease patients, (2) cardiac patients who suffer sudden haemodynamic deterioration, (3) patients with low cardiac output who require left heart decompression because of extracorporeal support, (4) patients with haemodynamically unstable arrhythmias and (5) haemodynamically unstable patients who require percutaneous coronary intervention. We also provide state-of-the-art information on the elective use of ECMO to support congenital and structural catheter interventions. Acute survival and long-term outcome are now related to the underlying conditions rather than complications of the catheterisation procedure itself.
Part of the book: Extracorporeal Membrane Oxygenation