Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10614-10621
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10614
Extracorporeal membrane oxygenation in curing a young man after modified Fontan operation: A case report
He-Bing Guo, Jian-Bo Tan, Yong-Chao Cui, Hao-Feng Xiong, Chuan-Sheng Li, Yu-Feng Liu, Yao Sun, Lin Pu, Pan Xiang, Ming Zhang, Jing-Jing Hao, Ning-Ning Yin, Xiao-Tong Hou, Jing-Yuan Liu
He-Bing Guo, Jian-Bo Tan, Hao-Feng Xiong, Chuan-Sheng Li, Yu-Feng Liu, Yao Sun, Lin Pu, Pan Xiang, Ming Zhang, Jing-Jing Hao, Ning-Ning Yin, Jing-Yuan Liu, Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Yong-Chao Cui, Xiao-Tong Hou, Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Author contributions: Liu JY and Hou XT designed the research study and provided research ideas; Guo Hb and Tan JB were major contributors in writing the manuscript; Cui YC, Xiong HF, Li CS, Liu YF, Sun Y, Pu L, Xiang P, Zhang M, Hao JJ, and Yin NN read the literature and collected the patient’s medical records; all authors read and approved the final manuscript.
Supported by the Capital Foundation of Medical Development, No. 2018-1-2171; and the Seedling Plan from the Beijing Ditan Hospital, Capital Medical University, No. DTYM201802.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Yuan Liu, MD, Associate Professor, Doctor, Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing 100015, China. dtyyicu@ccmu.edu.cn
Received: April 14, 2022
Peer-review started: April 14, 2022
First decision: July 11, 2022
Revised: July 14, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: October 16, 2022
Processing time: 163 Days and 0.9 Hours
Abstract
BACKGROUND

The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ hemodynamics. After successful operation, patients typically recover the ability to engage in general physical activity. As a better ventilatory strategy, extracorporeal membrane oxygenation (ECMO) provides gas exchange via an extracorporeal circuit, and is increasingly being used to improve respiratory and circulatory function. After the modified Fontan operation, circulation is different from that of patients who are not subjected to the procedure. This paper describe a successful case using ECMO in curing influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago. The special cardiac structure and circulatory characteristics are explored in this case.

CASE SUMMARY

We report a successful case using ECMO in curing influenza A infection in a 23-year-old man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago. The man was admitted to the intensive care unit with severe acute respiratory distress syndrome as a result of influenza A infection. He was initially treated by veno-venous (VV) ECMO, which was switched to veno-venous-arterial ECMO (VVA ECMO) 5 d later. As circulation and respiratory function gradually improved, the VVA ECMO equipment was removed on May 1, 2018. The patient was successfully withdrawn from artificial ventilation on May 28, 2018 and then discharged from hospital on May 30, 2018.

CONCLUSION

After the modified Fontan operation, circulation is different compared with that of patients who are not subjected to the procedure. There are certainly many differences between them when they receive the treatment of ECMO. Due to the special cardiac structure and circulatory characteristics, an individualized liquid management strategy is necessary and it might be better for them to choose an active circulation support earlier.

Keywords: Acute respiratory distress syndrome; Extracorporeal membrane oxygenation; Modified Fontan operation; Tausing-Bing syndrome; Case report

Core Tip: After the modified Fontan operation, circulation is different from that of patients who are not subjected to the procedure. In this article, we describe a 23-year-old man, with a history of modified Fontan operation for Tausing-Bing syndrome, who was admitted to the intensive care unit with severe acute respiratory distress syndrome as a result of influenza A infection. The man was initially treated by veno-venous extracorporeal membrane oxygenation (ECMO), which was switched to veno-venous-arterial ECMO 5 d later. As circulation and respiratory function gradually improved, the veno-venous-arterial ECMO equipment was successfully removed. Then, the man was discharged from hospital successfully. This case highlights that an individualized liquid management strategy is necessary and it might be better for such patients to choose an active circulation support earlier.