SUCCESSFUL TREATMENT OF A RECIPIENT WITH MASSIVE THROMBOSIS OF HEART TRANSPLANT LEFT CHAMBERS DURING EXTRACORPOREAL MEMBRANE OXYGENATION
https://doi.org/10.15825/1995-1191-2016-2-117-124
Abstract
We present a case report of a 16-year-old man with venoarterial extracorporeal membrane oxygenation (VA-ECMO) for primary graft failure after orthotopic heart transplantation who developed left atrium and left ventricular thrombosis despite systemic anticoagulation. The surgical thrombectomy was performed and the patient was successfully weaned off the extracorporeal support on the first day thereafter.
About the Authors
V. N. Poptsov
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow;
I.M. Sechenov First Moscow State Medical University, Moscow
Russian Federation
For correspondence: Poptsov Vitalii Nikolaevich. Address: 1, Shchukinskaya st., Moscow, 123182, Russian Federation. Tel. (963) 644-96-39. E-mail: poptsov_vit@mail.ru
Russian Federation
For correspondence: Poptsov Vitalii Nikolaevich. Address: 1, Shchukinskaya st., Moscow, 123182, Russian Federation. Tel. (963) 644-96-39. E-mail: poptsov_vit@mail.ru
V. M. Zakharevich
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow;
I.M. Sechenov First Moscow State Medical University, Moscow
Russian Federation
Russian Federation
E. A. Spirina
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
A. M. Golts
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
S. G. Ukhrenkov
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
T. A. Khalilulin
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow;
I.M. Sechenov First Moscow State Medical University, Moscow
Russian Federation
Russian Federation
E. Z. Aliev
V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow
Russian Federation
Russian Federation
References
1. D’Alessandro C, Golmard JL, Barreda E et al. Predictive risk factors for primary graft failure requiring temporary extra-corporeal membrane oxygenation support after cardiac transplantation in adults. Eur. J. Cardiothorac. Surg. 2011; 40 (4): 962–969.
2. Leprince P, Aubert S, Bonnet N et al. Peripheral extracorporeal membrane oxygenation (ECMO) in patients with posttransplant cardiac graft failure. Transplant Proc. 2005; 37: 2879–2880.
3. Madershahian N, Weber C, Scherner M et al. Thrombosis of the aortic root and ascending aorta during extracorporeal membrane oxygenation. Intensive care Med. 2014; 40: 432–433.
4. Tanaka D, Pitcher HT, Mather PJ, Entwistle JW. Massive Thrombosis of the Transplanted Heart in the Early Postoperative Period. J Card Surg. 2016; 31 (2): 117–119.
5. Santise G, Panarello G, Ruperto C, Turrisi M et al. Extracorporeal membrane oxygenation for graft failure after heart transplantation: a multidisciplinary approach to maximize weaning rate. Int J Artif Organs. 2014; 37: 706–714.
6. Arpesella G, loforte A, Mikus E, Mikus PM. Extracorporeal membrane oxygenation for primary allograft failure. Transplant Proc. 2008; 40: 3596–3597.
7. Kumar T, Zurakowski D, Dalton H et al. Extracorporeal membrane oxygenation in postcardiotomy patients: factors infl uencing outcome. J Thorac Cardiovasc Surg. 2010; 140: 330–336.
8. Annich GM. Extracorporeal life support: the precarious balance of hemostasis. Journal of Thrombosis and Haemostasis. 2015; 13: 336–342.
9. Urlesberger B, Zobel G, Zenz W et al. Activation of the clotting system during extracorporeal membrane oxygenation in term newborn infants. J Pediatr. 1996; 129 (2): 264–268.
10. Gorbet MB, Sefton MV. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials. 2004; 25 (26): 5681–5703.
11. Moubarak G, Weiss N, Leprince P, Luyt Ch. Massive intraventricular thrombus complicating extracorporeal membrane oxygenation support. Can J Cardiol. 2008; 24.
12. Ramje V, Shreeniva S, Rame JE et al. Complete spontaneous left heart and aortic thromboses on extracorporeal membrane oxygenation support. Echocardiography. 2013; 30: e342–343.
13. Muehrcke DD, McCarthy PM, Stewart RW, Seshagiri S, Ogella DA, Foster RC, Cosgrove DM. Complications of extracorporeal life support systems using heparin-bound surfaces. The risk of intracardiac clot formation. J Thorac Cardiovasc Surg. 1995; 110 (3): 843–851.
14. Slottosch I, Liakopoulos O, Kuhn E et al. Outcomes after peripheral extracorporeal membrane oxygenation therapy for postcardiotomy cardiogenic schock: a single-center experience. J Surg Resaech. 2013; 181: E47–E55.
15. Syburra T, Lachat M, Genoni M et al. Fatal outcome of recombinant factor VIIa in heart transplantation with extracorporeal membrane oxygenation. Ann Thorac Surg. 2010; 89: 1643–1645.
16. Derumeaux G, Mouton-Schleifer D, Soyer R et al. High incidence of left atrial thrombus detected by transoesophageal echocardiography in heart transplant recipients. Eur Heart J. 1995; 16: 120–125.
17. Castedo E, Burgos R, Canas A et al. Left atrial thrombosis after heart transplantation. Сardiovasc Surg. 2003; 3: 247–249.
18. Lew AS, Federman J, Harper RW et al. Operative removal of mobile pedunculated left ventricular thrombus detected by 2-dimensional echocardiography. Am J Cardiol. 1983; 52: 1148–1149.
19. Seitz MJ, McLeod MK, O’Keefe MD, Seah PW. A rare cause of Takotsubo cardiomyopathy related left ventricular apical thrombus requiring surgery. Heart Lung Circ. 2012; 21 (4): 245–246.
20. Nili M, Deviri E, Jortner R et al. Surgical removal of a mobile, pedunculated left ventricular thrombus: report of 4 cases. Ann Thorac Surg. 1988; 46: 396–400.
21. Garcia A, Gander JW, Gross ER et al. The use of recombinant tissue-type plasminogen activator in a newborn with an intracardiac thrombus developed during extracorporeal membrane oxygenation. Pediatr Surg. 2011; 46: 2021–2024.
22. Koster A, Weng Y, Böttcher W, Gromann T, Kuppe H, Hetzer R. Successful use of bivalirudin as anticoagulant for ECMO in a patient with acute HIT. An Thorac Surg. 2007; 83: 1865–1867.
23. Sangalli F, Greco G, Galbiati L et al. Regional thrombolysis with tenecteplase during extracorporeal membrane oxygenation: a new approach for left ventricular thrombosis. J Card Surg. 2015; 30: 541–543.
24. Zenz W, Arlt F, Sodia S et al. Intracerebral hemorrhage during fibrinolytic therapy in children: a review of the literature of the last thirty years. Sem Thromb Hemost. 1997; 23: 321–332.
Review
For citations:
Poptsov V.N., Zakharevich V.M., Spirina E.A., Golts A.M., Ukhrenkov S.G., Khalilulin T.A., Aliev E.Z. SUCCESSFUL TREATMENT OF A RECIPIENT WITH MASSIVE THROMBOSIS OF HEART TRANSPLANT LEFT CHAMBERS DURING EXTRACORPOREAL MEMBRANE OXYGENATION. Russian Journal of Transplantology and Artificial Organs. 2016;18(2):117-124. (In Russ.) https://doi.org/10.15825/1995-1191-2016-2-117-124
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