Journal of Pediatric Cardiology and Cardiac Surgery

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely used for severe circulatory failure and can be deployed quickly and easily even in small infants. Cardiac function, however, does not recover soon in some patients, who eventually die when the heart becomes unable to pump the blood out through the aortic valve, end-diastolic pressure of the left ventricle (LV) is elevated, pulmonary venous congestion progresses and myocardial recovery is disturbed in the LV. In this situation, LV decompression is of practical use. We report herein a successful case of aortic valvuloplasty in a female infant requiring ECMO with LV venting for severely reduced LV function and LV hypertrophy. LV distention and pulmonary congestion were prevented, and the patient was weaned off ECMO. Decompressing the left side of the heart in a timely manner may be essential according to the patient’s hemodynamic profile.