Korean Circ J.  2011 Jul;41(7):402-404. 10.4070/kcj.2011.41.7.402.

Percutaneous Transseptal Left Atrial Drainage for Decompression of the Left Heart in an Adult Patient during Percutaneous Cardiopulmonary Support

• Kang MH
• Hahn JY
• Gwon HC
• Song YB
• Choi JO
• Choi JH
• Choi SH
• Lee SH
• Jeon ES

• KMID: 2225105
• DOI: http://doi.org/10.4070/kcj.2011.41.7.402

Abstract

A 28-year-old male with hemophagocytic lymphohistiocytosis presented with left ventricular dysfunction and cardiac arrest. Percutaneous cardiopulmonary support (PCPS) was initiated, but left heart distension developed with associated aggravation of pulmonary edema. Percutaneous transseptal left atrial sheath (28-Fr) drainage was incorporated into the PCPS venous circuit under fluoroscopic guidance to enable left heart decompression 1 days after PCPS initiation. The patient's pulmonary edema improved markedly, and distention of his left heart diminished. He was successfully weaned from PCPS 5 days later. Percutaneous transseptal left atrial drainage with large venous cannulae is feasible and effective in decompressing the left heart in adult patients during PCPS.

Keyword

Heart arrest; Assisted circulation; Heart catheterization

MeSH Terms

Adult
Assisted Circulation
Cardiac Catheterization
Catheters
Decompression
Drainage
Heart
Heart Arrest
Humans
Lymphohistiocytosis, Hemophagocytic
Male
Pulmonary Edema
Ventricular Dysfunction, Left

Figure

• 

  Fig. 1 Chest radiographs showing interval change over time since percutaneous cardiopulmonary support initiation. A: anteroposterior chest radiograph illustrating percutaneous cardiopulmonary support initiation. B: chest radiograph showing severe pulmonary edema and left heart distension developed shortly after percutaneous cardiopulmonary support initiation.

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  Fig. 2 Anteroposterior chest radiograph following percutaneous transseptal left atrial drainage while on percutaneous cardiopulmonary support, with left heart decompression and subsequent improvement of pulmonary edema.

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