Body Region: Cardiovascular
Author: Christian Loewe, Vienna, Austria
1. Patient presentation
- An 80-year-old man initially presented with severe mitral valve regurgitation and multivessel coronary artery disease.
- Mitral valve reconstruction and coronary bypass graft surgery were performed.
- Due to a prolonged postoperative phase complicated by acute respiratory distress syndrome (ARDS) and a third-degree atrioventricular bundle block, a system for extracorporeal membrane oxygenation (ECMO) was implanted.
- ECMO support had to be left in place for two weeks, as two attempts at discontinuation failed. In addition, two hemorrhagic episodes caused by the ECMO cannulas occurred.
- After 2 weeks the situation worsened further and the patient was referred for CT because of acute abdomen and raised lactate levels (Figures 1 and 2).