Application of ballon atrial septostomy for left heart venting during extracorporeal membrane oxygenation

Objective To discuss whether balloon atrial septostomy(BAS) can provide safe and effective left ventricular venting for venoarterial extracorporeal membrane oxygenation(V-A ECMO). Methods From March 2017 to January 2019, 9 patients received BAS for left ventricular venting during V-A ECMO treatment in our hospital, including 5 males and 4 females, aged 12-72 years. There were 3 cases of severe myocarditis, 4 cases of low cardiac output after cardiac surgery, and 2 cases of acute myocardial infarction. Basic data, procedure data, outcome and follow-up were recorded. Results BAS were successfully performed in 9 patients. Procedure time on average was 42.2 min. Anterior mediastinal hematoma occurred in 1 case. There were no other procedure-related complications in the rest cases. No pulmonary edema or thrombosis occurred in all 9 cases during ECMO. No closure procedure was performed. Conclusion BAS is a safe and effective method for left ventricular venting. The procedure is conductive to the recovery of patients with severe left heart failure. Key words: Atrial septostomy; Transseptal puncture; Extracorporeal membrane oxygenation; Left ventricular venting