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- Title
Extracorporeal membrane oxygenator as a bridge to definitive treatment in patients with persistent infective endocarditis.
- Authors
Fereydooni, Soraya; Hu, Kevin; Shang, Michael; Vallabhajosyula, Prashanth
- Abstract
Considering the worsening opioid epidemic, complicated infective endocarditis (IE) secondary to intravenous drug use (IVDU) that fails medical management is increasingly common. We present a 31-year-old patient post tricuspid valve replacement who relapsed with recurrent IE and secondary complications of severe tricuspid stenosis and regurgitation, ventricular septal defect (VSD), pulmonary emboli, right-sided heart failure with severe hepatic congestion, and cardiogenic shock. Despite maximal medical management, the patient remained in septic and cardiogenic shock with a potential disposition to hospice care. Upon consulting cardiothoracic surgery, she underwent a first-stage valvectomy with central Extracorporeal Membrane Oxygenation (ECMO) as a bridge to definitive treatment. After clearance of infection, she underwent a second-stage valve replacement, VSD repair, and final ECMO decannulation. Our case alludes to ECMO as a potential bridge for patients with complicated infective endocarditis who fail medical management and are high-risk candidates for immediate definitive surgical management.
- Subjects
METHADONE treatment programs; PULMONARY embolism; CARDIOGENIC shock; TRICUSPID valve; ANTIBIOTICS; PHYSICAL therapy; EXTRACORPOREAL membrane oxygenation; INFECTION; ENDOCARDITIS; HEART valve diseases; HEART failure; FEVER; METHICILLIN-resistant staphylococcus aureus; ANGIOGRAPHY; CHRONIC diseases; REINFECTION; BACKACHE; CHRONIC hepatitis C; ECHOCARDIOGRAPHY; BUPRENORPHINE; SPEECH therapy; DISEASE complications
- Publication
Perfusion, 2024, Vol 39, Issue 4, p836
- ISSN
0267-6591
- Publication type
Article
- DOI
10.1177/02676591231158498