Application of ECMO in a Patient with Post-Cardiotomy Cardiogenic Shock Combined with Dextrocardia: Case Report

Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) is a widely-accepted salvage therapy for patients with refractory cardiogenic shock (CS). CS often presents with mirror-image dextrocardia and other cardiac abnormalities, making surgical management of CS challenging. The use of VA-ECMO and an intra-aortic balloon pump (IABP) to address CS combined with dextrocardia has not been reported previously. In this case report, we summarize our experience treating perioperative CS using VA-ECMO and IABP in a male patient with dextrocardia combined with coronary artery disease (CAD). During off-pump coronary artery bypass (OPCAB), the patient developed CS and underwent emergency transfer to on-pump coronary artery bypass (ONCAB). The patient then received ECMO and an IABP, which successfully restored hemodynamic function. The patient was eventually discharged from the hospital without further complications.