Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 33(1): 69-75 (2017)

症例報告Case Report

ECMO下にCT検査を施行した先天性心疾患小児3例の検討:有用性,安全性,限界についてComputed Tomography for Three Pediatric Patients with Congenital Heart Disease during Extracorporeal Membrane Oxygenation: Efficacy, Safety, and Limitations

1国立循環器病研究センター小児循環器科Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center ◇ Osaka, Japan

2国立循環器病研究センター放射線部Department of Radiology, National Cerebral and Cardiovascular Center ◇ Osaka, Japan

3奈良県立医科大学附属病院小児科Department of Pediatrics, Nara Medical University Hospital ◇ Nara, Japan

4国立循環器病研究センター小児心臓外科Department of Pediatric Cardiac Surgery, National Cerebral and Cardiovascular Center ◇ Osaka, Japan

受付日:2016年10月18日Received: October 18, 2016
受理日:2016年12月24日Accepted: December 24, 2016
発行日:2017年1月1日Published: January 1, 2017







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.

Key words: multi-detector row CT; extracorporeal membrane oxygenation; pediatric congenital heart disease

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