日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

The use of extracorporeal membrane oxygenation (ECMO) is increasing in the field of pediatric cardiac diseases. Therefore, a detailed estimation of the anatomy and hemodynamics is necessary for determining the treatment strategy. Multi-detector row computed tomography (CT) is extremely beneficial as a diagnostic modality.

We performed CT examinations in three cases of pediatric congenital heart disease under ECMO support.

Case 1: A 4-month-old female presented with asplenia, right single ventricle, and pulmonary stenosis after pulmonary–systemic artery shunt surgery. The shunt became occluded; therefore, ECMO was introduced. Enhanced CT examination was performed before pulmonary blood flow reconstruction.

Case 2: A 1-month-old female presented with right single ventricle, pulmonary stenosis, pulmonary artery (PA) sling, and hypoplastic trachea. She had respiratory failure and was intubated. When her hypoxemia did not improve, ECMO was introduced and enhanced CT examination was performed before relief of the PA sling.

Case 3: A 5-year-old male presented with congenitally corrected transposition of the great artery after a double switch operation. He developed respiratory failure due to interstitial pneumonia; therefore, ECMO was introduced. Plain CT examination was performed to judge the effect of treatment and to determine the secession from ECMO.

Accurate preparation and support from specialists made the CT examination safe in every case, and we were able to obtain the information essential for determining the mode of treatment. For beneficial and safe CT examinations under ECMO, establishment of protocols, assurance from medical specialists, and proper preparation for the procedure are necessary.