Extracorporeal membrane pulmonary oxygenation combined with intra-aortic balloon counterboost to rescue low cardiac output after coronary artery bypass grafting

The patient, a 41-year-old male, had a stent placed in the anterior descending branch and a stent placed in the ileocecal branch 6 years ago due to acute coronary syndrome, and was hospitalized in Beijing Anzhen Hospital 1 month ago. On July 25, 2004, the patient underwent coronary artery bypass grafting under general anesthesia with extracorporeal circulation: the left internal mammary artery was anastomosed with the anterior descending branch, and the saphenous vein was sequentially anastomosed from the ascending aorta to the gyrus branch and the posterior descending branch, and the bridge flow was measured satisfactorily. However, it was difficult to stop extracorporeal circulation. However, it was difficult to stop the extracorporeal circulation. The extracorporeal circulation was successfully stopped with the aid of IABP implantation in the right femoral artery and extracorporeal membrane pulmonary oxygenation (ECMO) cannulation in the left femoral artery. The patient was safely withdrawn after 5 days of ECMO assistance and 9 days of IABP assistance. The patient successfully survived the complications of low cardiac output, infection and respiratory failure, and was discharged from the hospital after 21 days of postoperative stay. Song Shiqiu, Cardiac Surgery Center, Beijing Anzhen Hospital Extracorporeal membrane oxygenation (ECMO) is a new method of using bioengineering technology to save the lives of dying patients; it is derived from extracorporeal circulation in cardiac surgery, which allows the heart and lungs to rest fully by replacing all or part of the cardiopulmonary function with extracorporeal equipment for a longer period of time, so as to buy time for the healing and functional recovery of heart and lung lesions. When ECMO is in operation, blood is drawn from a vein and absorbs oxygen and expels carbon dioxide through the membrane lung, which can replace the functions of the heart and lungs. Therefore, it can be used for both respiratory support and cardiac support. When the patient’s cardiopulmonary function is severely impaired and conventional treatment is ineffective, ECMO can assume the gas exchange and heart pumping functions to maintain blood circulation and gain valuable time for the patient’s recovery.     In recent years, in the cardiac surgery department of Beijing Anzhen Hospital, Capital Medical University, more and more patients with critical coronary artery disease are receiving surgical treatment, and we are the first in China to apply extracorporeal membrane pulmonary oxygenation (ECMO) combined with intra-aortic balloon counterboost (IABP) to rescue and treat low cardiac output syndrome after coronary artery bypass grafting, which has become a routine treatment measure. The success rate of timely application is over 80%, which provides strong life support for patients and greatly improves the success rate of bypass surgery for critically ill patients.