First successful use of Central Veno-Arterial ECMO in the State of Uttar Pradesh

First successful use of Central Veno-Arterial ECMO in the State of Uttar Pradesh to save the precious life of this 45-year-old gentleman who was admitted on 7th of December 2019 as a case RHD with severe calcific Mitral Senosis with severe PAH with severe TR in CHF with severe bronchospasm with severe hepato-renal dysfunction with jaundice and oliguria. He was managed for 20 days on medical treatment and was posted for Mitral Valve Replacement and repair of TV Valve. On the day of operation, he developed severe bronchospasm with pulmonary oedema leading to respiratory arrest and was placed on Ventilator. Lungs spasm was so severe that ventilator failed to expand the lungs. Saturation started dropping to less than 60 with FIO2 of 100% and PaO2 of 40 mm Hg. Finally, with the help of Bain Circuit, he could be little ventilated. At this stage, his family was counselled for use of ECMO after complications of Open Heart Surgery. They agreed and the patient underwent successful MVR with TV Repair. He came off from CPB successfully but lungs again could not be ventilated and saturation started dropping to 50 to 60 on 100% of FIO2. At this stage, he was placed on ECMO using RA venous cannula for venous return and aortic cannula for arterial return. He was assisted by ECMO for 26 hours. Thereafter his lungs started working with 40% of FIO2, PaO2 was more than 150 mm of Hg. Then ECMO was weaned off in Operating Room and chest was closed. Today is his 14th postoperative day. He has no infection. The wound has healed and liver and renal parameters have become normal. Had ECMO been not there, he would not be alive today. We are hopeful that in the near future we shall be able to save several lives.
I congratulate the team ECMO comprising of Cardiac Surgeons: including me, Dr Pankaj Kumar Srivastava, Dr Bhupendra Kumar. Cardiac Anesthetists: Prof Rajeev Lakhotya, Dr K P Mall. Cardiologists Dr Ayush Shukla, Dr Ambukeshwar Singh. Pediatrician Dr Tarun Anand Blood bank in charge Dr Dipti Singh. Perfusionist Mr S V Singh, ICU Technician Rajesh and Kamla Pandit and other trained staff nurse and paramedicals. I congratulate all ECMO team members of Divine Heart and Multispcialty Hospital for their great efforts which has brought laurel in the society.
Dr (Prof) A K Srivastava.

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