Various Heart Surgery Procedures

Bypass Surgery (Coronary Artery Bypass Surgery or CABG)

Bypass surgery is the most common type of heart surgery with more than 20,000 procedures performed each year in India.

Arteries can become clogged over time by the build up of fatty plaque. Bypass surgery improves the blood flow to the heart with a new route or “bypass” around a section of clogged or diseased artery.

The surgery involves using a section of blood vessel from the leg, chest, or another part of the body to graft onto the affected coronary artery, thus bypassing the clogged or diseased section.

during bypass surgery

During bypass surgery, the breastbone (sternum) is divided, the heart is stopped, and blood is sent through a heart-lung machine or more commonly without stopping the heart (called beating heart surgery). Unlike other forms of heart surgery, the chambers of the heart are not opened during the operation. Some bypass procedures can be done as limited-access surgery, described below as minimally invasive bypass.

What to Expect

The operation will be scheduled at a time that is best for you and your surgeon, except in urgent cases. Be sure your surgeon and cardiologist know about any changes in your health including symptoms of a cold or the flu. Any infection may affect your recovery.

Also, review all medications (prescription as well as over-the-counter and supplements) with your cardiologist and surgeon.

Before surgery, you may have to have an electrocardiogram (ECG or EKG), blood tests, urine tests, and a chest x-ray to give your surgeon the latest information about your health.

If you smoke, your doctor will want you to stop at least 2 weeks before your surgery. Smoking before surgery can lead to problems with blood clotting and breathing.

The night before surgery, you will be asked to bathe to reduce the amount of germs on your skin.

A medicine (anaesthetic) will make you sleep during the operation. This is called “anaesthesia.” Because anaesthesia is safest on an empty stomach, you will be asked not to eat or drink after midnight the night before surgery. If you do eat or drink anything after midnight, it is important that you tell your anaesthesiologist and surgeon.

You will get complete instructions from your cardiologist and surgeon about the procedure, but here are some basics you can expect as a bypass patient.

Day of Surgery

Most patients are admitted to the hospital the day before surgery or, in some cases, on the morning of surgery.

Small metal disks called electrodes will be attached to your chest. These electrodes are connected to an electrocardiogram machine, which will monitor your heart’s rhythm and electrical activity. You will receive a local anaesthetic to numb the area where a plastic tube (called a line) will be inserted in an artery in your wrist. An intravenous (IV) line will be inserted in your vein. The IV line will give you the anaesthesia during the operation. You will be given something to help you relax (a mild tranquilizer) before you are taken into the operating room.

After you are completely asleep, a tube will be inserted down your windpipe and connected to a machine called a respirator, which will take over your breathing. Another tube will be inserted through your nose and down your throat, into your stomach. This tube will stop liquid and air from collecting in your stomach, so you will not feel sick and bloated when you wake up. A thin tube called a catheter will be inserted into your bladder to collect any urine produced during the operation.

A heart-lung machine is used for most bypass operations. A perfusion technologist or blood-flow specialist operates the machine. Before you are hooked up to this machine, a blood-thinning medicine called an anticoagulant will be given to prevent your blood from clotting. The surgical team is led by the cardiovascular surgeon and includes other assisting surgeons, an anaesthesiologist, and surgical nurses.

After you are hooked up to the heart-lung machine, your heart is stopped and cooled.

A long piece of vein from your leg (the saphenous vein) may be removed for the graft. One end of the graft will be attached to the ascending aorta, the large artery that carries oxygen-rich blood out of the top of the heart to the body. The other end of the graft will be attached to the affected coronary artery below the blocked area. The surgeon may choose to use an artery from the inside of your chest wall (the internal mammary artery) instead or the surgeon may use both for grafts. The procedure can take from 2 to 6 hours, depending on the number of bypasses needed.

Recovery Time

You can expect to stay in the hospital for about a week, including at least 1 to 3 days in the Intensive Care Unit (ICU).

Life After Bypass

After bypass surgery, your doctor will recommend that you join a cardiac rehabilitation program. These programs help you make lifestyle changes such as; modifying your diet, exercising to get your strength back, quitting smoking, maintaining a healthy weight, and learning to deal with stress.

Because bypass surgery does not cure the underlying heart disease (atherosclerosis or coronary artery disease), medicines will be an important part of your treatment after the surgery. You will most likely need to take statin or other cholesterol-lowering medicines and begin antiplatelet therapy.

If you have an office job, you can usually go back to work in 4 to 6 weeks. Those who have more physically demanding jobs may need to wait longer.

Minimally Invasive Bypass Surgery

Minimally invasive coronary artery bypass surgery is done through smaller incisions and the procedure may be done without stopping the heart. Some patients can even leave the hospital within 48 hours. This operation is only used for patients whose blockages can be bypassed through this smaller incision and whose risk of complications is low.

Some common facts about bypass surgery:

  • Most people are fit enough in 3 weeks time.
  • Can drive, swim, join Gymnasium and have normal sex life in 4 weeks.
  • If the procedure is done through a mini or key-hole cut then patient can join back work just in 2 weeks time!!

Speciality about Bypass performed by Dr. Ritwick:

  • Very high success rate up to 99% for most of the cases.
  • Extremely patient friendly.
  • Almost Zero Blood loss or bleeding and hence no blood transfusion.
  • Wonderfully painless.
  • Maximum use of arteries and LESS OR NO USE OF VEINS FROM LEGS (arteries last almost 15 years longer than leg veins).
  • Most patients join back work within a month’s time.

Minimal access CABG or Key hole CABG

Several minimally invasive techniques for treating coronary artery disease — in which a fatty build-up inside the arteries blocks blood flow to the heart.

With CABG, a surgeon takes a section of a healthy blood vessel from the patient’s leg, chest, or arm and connects it (grafts it) to their coronary artery slightly past the site of the blockage. This creates a new path for blood to flow around (bypass) the blockage in the artery so it can get to the heart.

In traditional off-pump CABG (OPCAB), a large incision is made in the patient’s chest. This gives the surgeon access to the heart and is needed to accommodate a stabilization system that keeps the beating heart steady so the surgeon can sew on the replacement blood vessel.

However, a minimally invasive stabilization system can be inserted via small incisions on the sides of the chest. The system includes a heart positioner that holds the heart in a position that gives the surgeon access to the blocked arteries, and a tissue stabilizer that holds a small area of the heart still while the surgeon works on it.
Our innovative placement of the stabilization system allows the surgeon to make a much smaller incision near the heart. When this technique and product are combined with our other minimally invasive techniques and products for CABG, the results can be significant.

Studies show this minimally invasive procedure results in shorter hospital stays and a faster return to daily living.

 

(Courtesy – Medtronic Inc.)

Benefits of Key-Hole Bypass:

  • Very cosmetic
  • Painless
  • Early discharge in 3 days from hospital
  • Early return to work

Heart Valve Operations

Heart valve surgery is used to repair or replace diseased heart valves.

Blood that flows between different chambers of your heart must flow through a heart valve. Blood that flows out of your heart into large arteries must also flow through a heart valve.

These valves open up enough so that blood can flow through. They then close, keeping blood from flowing backward.

There are four valves in your heart:

  • Aortic valve
  • Mitral valve
  • Tricuspid valve
  • Pulmonic valve

The aortic valve is the most common valve to be replaced because it cannot be repaired. The mitral valve is the most common valve to be repaired. Only rarely is the tricuspid valve or the pulmonic valve repaired or replaced.

Description

Before your surgery you will receive general anaesthesia. You will be asleep and unable to feel pain.

In open heart surgery, the surgeon makes a large surgical cut in your breastbone to reach the heart and aorta. You are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart, providing oxygen and removing carbon dioxide.

Minimally invasive valve surgery is done through much smaller cuts than open surgery, or through a catheter inserted through the skin.

Several different techniques are used:

  • Percutaneous surgery (through the skin)
  • Robot-assisted surgery

If your surgeon can repair your mitral valve, you may have:

  • Ring annuloplasty —The surgeon repairs the ring-like part around the valve by sewing a ring of plastic, cloth, or tissue around the valve.
  • Valve repair —The surgeon trims, shapes, or rebuilds one or more of the leaflets of the valve. The leaflets are flaps that open and close the valve. Valve repair is best for the mitral and tricuspid valves. The aortic valve is usually not repaired.

If your valve is too damaged, you will need a new valve. This is called valve replacement surgery. Your surgeon will remove your valve and put a new one in place.

The main types of new valves are:

  • Mechanical — made of man-made materials, such as metal (stainless steel or titanium) or ceramic. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
  • Biological — made of human or animal tissue. These valves last 12 – 15 years, but you may not need to take blood thinners for life.

Mechanical and Biological Heart Valve (Courtesy: St. Jude Inc.)

In some cases, surgeons can use your own pulmonic valve to replace the damaged aortic valve. The pulmonic valve is then replaced with an artificial valve (this is called the Ross Procedure). This procedure may be useful for people who do not want to take blood thinners for the rest of their life. However, the new aortic valve does not last very long and may need to be replaced again by either a mechanical or a biologic valve.

Why The Procedure is Performed

You may need surgery if your valve does not work properly.

A valve that does not close all the way will allow blood to leak backwards. This is called regurgitation.

A valve that does not open fully will limit forward blood flow. This is called stenosis.

You may need heart valve surgery for these reasons:

  • Defects in your heart valve are causing major heart symptoms, such as chest pain (angina), shortness of breath, fainting spells (syncope), or heart failure.
  • Tests show that the changes in your heart valve are beginning to seriously affect your heart function.
  • Your doctor wants to replace or repair your heart valve at the same time as you are having open heart surgery for another reason, such as a coronary artery bypass graft surgery.
  • Your heart valve has been damaged by infection (endocarditis).
  • You have received a new heart valve in the past and it is not working well, or you have other problems such as blood clots, infection, or bleeding.

Some of the heart valve problems treated with surgery are:

  • Aortic insufficiency
  • Aortic stenosis
  • Congenital heart valve disease
  • Mitral regurgitation – acute
  • Mitral regurgitation – chronic
  • Mitral stenosis
  • Mitral valve prolapse
  • Pulmonary valve stenosis
  • Tricuspid regurgitation
  • Tricuspid Valve Stenosis

In India, about 80% of the valve replacements and repair surgeries are done on patients who have suffered from Rheumatic fever in childhood. This process leads to inflammation on the heart valve leading to various kinds of diseases involving multiple valves.

Before The Procedure

Your preparation for the procedure will depend on the type of valve surgery you are having:

  • Aortic valve surgery – minimally invasive
  • Aortic valve surgery – open
  • Mitral valve surgery – minimally invasive
  • Mitral valve surgery – open

After The Procedure

Your recovery after the procedure will depend on the type of valve surgery you are having:

  • Aortic valve surgery – minimally invasive
  • Aortic valve surgery – open
  • Mitral valve surgery – minimally invasive
  • Mitral valve surgery – open

The average hospital stay is 5 – 7 days. The nurse will tell you how to care for yourself at home. Complete recovery will take a few weeks to several months, depending on your health before surgery.

Outlook (Prognosis)

The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life.

Mechanical heart valves do not often fail. Artificial valves last an average of 8 – 20 years, depending on the type of valve. However, blood clots can develop on these valves. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.

There is always a risk of infection. Talk to your doctor before having any type of medical procedure.

The clicking of mechanical heart valves may be heard in the chest. This is normal.

Video Assisted Key Hole Mitral Valve Procedure

It’s a special area of interest for Dr. Ritwick and his entire team in Max healthcare. This procedure again has the following advantages:

  • Cosmetic scar
  • Painless
  • No bleeding
  • Can go out of hospital in 3 days
  • Can go back to work in 15 days time
  • For girls no hassle for getting married, having pregnancy.
  • For older patients’ easy recovery as the breast bone is not cut.

Thoracic Aneurysm Surgery

A thoracic aortic aneurysm, an abnormal bulge in a weakened wall of the aorta in the chest area, can cause a variety of symptoms and often life-threatening complications. Due to the serious risks it presents, timely diagnosis and treatment of a thoracic aneurysm are critical.

What is the best treatment for a thoracic aortic aneurysm?

The decision on how to best treat a thoracic aneurysm or the aorta depends on its size and rate of its growth, location and your overall health. The risk of rupture increases when the aneurysm is larger than about twice the normal diameter of a healthy aorta blood vessel.

Medical Management

If a thoracic aneurysm is small and causes no symptoms, your physician may recommend “watchful waiting,” which includes:

  • Close monitoring of the aneurysm with CT or MRI scans every 6 months.
  • Blood pressure medication to control high blood pressure, and decrease pressure on the weakened area of the aneurysm.
  • Restriction of some physical activities. Heavy lifting should be avoided as increased pressure on the aorta, may put an aneurysm at risk of rupture.

Surgery

The decision to treat a thoracic aneurysm with surgery is determined by many factors, including:

  • If the symptoms include chest, back pain, pain in the jaw, neck and upper back.
  • If the aneurysm is growing more than 1 (cm) centimeter per year.
  • Signs of an aortic dissection, including sudden, severe sharp tearing pain in the chest or back.
  • The age of the patient and the patient’s overall medical condition.

New evidence has shown that the size of the aneurysm in addition to a patient’s height plays an important role in the decision for surgery. While 5 centimetres is the size most aneurysms are considered for surgery, Cleveland Clinic surgeons have compiled years of experience and published studies to find that a patient’s height and their aneurysm’s size strongly correlates with the need for surgery.

Due to highly individualized characteristics guiding the decision for surgery, it is best that a physician regularly monitors patient’s thoracic aneurysm.

How Is A Thoracic Aneurysm Treated With Surgery

The current standard surgical treatment of a thoracic aortic aneurysm is the open-chest approach. The main purpose of open-chest surgery to treat a thoracic aneurysm is to replace the weakened portion of the aorta with a fabric tube, called a graft.

Repairing a thoracic aneurysm is surgically complicated and requires an experienced thoracic surgical team. However, neglecting the aneurysm presents a higher risk.

At Max Healthcare we have a dedicated team lead by Dr. Ritwick who has performed these procedures with results similar to international standards.

Aortic Dissection Surgery

At Max Cardiac Surgical Centre in Patparganj, doctors and surgeons collaborate to quickly determine the best treatment for an aortic dissection, which is a tear in the wall of the aorta, the largest artery in the body. Because some types of aortic dissections require emergency surgery, our experts work to accurately diagnose the condition and determine the best treatment as quickly as possible.

We are highlighting this fatal condition, as Max Patparganj is one of the very few centres in the country that runs a 24×7 Aortic dissection service. The cardio vascular team lead by Dr. Ritwick has performed a large number of such complex procedures with excellent outcome.

Treatment for aortic dissection may include medication or surgery.

Types of Aortic Dissection:

The aorta—a candy cane–shaped blood vessel originating in the chest at the top of the heart and extending into the abdomen—is the largest artery in the body. Like other arteries, it carries oxygen-rich blood from the heart to the rest of the body. The walls of the aorta consist of three layers that give it strength.

An aortic dissection or tear in the aorta typically occurs when the inner layer of the artery’s wall weakens. A small tear forms in this layer and if left untreated, it can enlarge.

Blood can pass through the tear into the middle layer of the wall, causing the layers to separate from one another or dissect. This can lead to the formation of a new channel, called a false lumen, between the two layers. This false lumen can extend from the tear to the lowest part of the aorta, preventing blood from flowing properly to the rest of the body.

The separation of the inner layer of the aorta forms a flap or septum, which can have multiple holes; known as re-entry tears, that have a Swiss cheese appearance. These tears allow blood to flow between the true lumen or natural passageway and the false lumen. If the flap doesn’t peel away from the aorta, blood can pool in the false lumen.

Over time, the blood in the false lumen can back up and clot, cutting off blood flow to other organs and further weakening the aortic wall. Sometimes, the blood breaks through the outer layer of the aorta, causing a life-threatening loss of blood and drop in blood pressure that requires immediate surgery.

Aortic dissection can lead to serious complications including; heart attack, kidney failure, stroke, paralysis, and intestinal ischemia in which blood vessels to the intestines becomes blocked. It can also cause lower extremity ischemia or blockages in the blood vessels of the legs.

Because the risks and appropriate treatments can be markedly different depending on the type of aortic dissection, it is crucial to accurately diagnose this condition.  The type of aortic dissection is based on the location of the tear and the duration of the symptoms. There are two types of aortic dissection, Type A and Type B.

Type A Aortic Dissection

If the aortic dissection occurs in the ascending aorta, the curved part of the aorta that extends upward from the heart, it’s called a Type A aortic dissection. A Type A tear may extend along the upper part of the aorta and down toward the abdomen.

Type A is more common than Type B. It’s also more dangerous, because it’s more likely to cause the aorta to rupture, leading to a potentially fatal heart condition.

Although this type of dissection sometimes causes no symptoms, it is more often accompanied by shortness of breath and a sudden, severe, sharp pain that feels like a tearing in the chest and upper back. It requires immediate surgery.

Type B Aortic Dissection

A Type B aortic dissection originates in the descending aorta, which extends from the arch at the top of the ascending aorta—the part that extends upward from the heart—in the chest to the bottom section of the aorta, also known as the abdominal aorta.

This type of dissection is usually treated with medications and monitoring by a doctor, because it rarely causes life-threatening side effects. Occasionally, Type B dissections can reduce or block blood flow to organs, such as the kidneys and the intestines, requiring surgery.

Symptoms may include high blood pressure and a severe, sharp back pain that can feel like it is extending into the chest or abdomen.

Acute Aortic Dissection

Both Type A and Type B aortic dissections are further diagnosed by doctors as being either acute or chronic. The majority of aortic dissections are acute, meaning the tear causes symptoms immediately and can be life threatening.

Types of Aortic Dissection

Acute aortic dissection causes sudden chest or back pain or both. Because the condition can lead to a rupture of the aorta, it requires immediate medical attention, usually surgery.

Chronic Aortic Dissection

Sometimes symptoms of an aortic dissection are vague and nonspecific and may go unnoticed until the tear begins to cause other complications. When these symptoms occur, or if imaging tests show signs that the condition has been present two weeks or longer, it is called chronic aortic dissection. Most chronic aortic dissections are Type B.

After you receive a diagnosis, your doctor monitors the chronic dissection with CT scans or a type of MRI scan called a magnetic resonance angiogram. These imaging tests can reveal a rapid expansion of the aorta, which can signify a blood clot or an aortic aneurysm, in which the aorta bulges, necessitating surgery. Medications are often prescribed to help reduce the flow of blood against the aortic wall.

Surgical Treatment

Surgeons either insert a tube called a stent to prevent blood from flowing into the false lumen that forms between the layers of the aorta during a dissection, or they replace the damaged parts of the aorta with a synthetic material.

Endovascular Surgery

Although most Type B aortic dissections are treated with medication, you may need surgery if you develop ischemia, a condition in which the dissection prevents the flow of blood to certain organs or to the legs.

Your doctor may recommend endovascular surgery to remove the blockage. In this minimally invasive procedure, the surgeon makes small incisions in the groin to access the femoral artery in the leg, which allows the doctor to reach the aorta. If necessary, small incisions can be made in the chest instead of the groin.

A thin wire is advanced through the artery and to the area near the aortic dissection, always staying within the true lumen, or natural passageway, of the aorta. The surgeon fits a thin tube called a sheath over the wire, slides it to the location of the dissection, and withdraws the wire.

He or she then guides a stent graft, a fabric tube covered with a metal mesh, through the sheath to the dissection. The surgeon expands the stent graft to fit the diameter of the aorta.

The stent supports the aorta, allowing it to heal by cutting off the blood flow to the false lumen, which is a new channel for blood flow that was created by the tear in the aortic wall. It also reinforces the aorta and can therefore prevent an aortic aneurysm or bulging of the aortic wall from developing in the weakened aorta.

Sometimes, the surgeon uses a “fenestrated” stent graft, which is customized to fit the person’s aorta and has specifically placed holes or fenestrations that allow blood to flow to the arteries that lead to important organs, such as the kidneys. This device allows the surgeon to repair the aorta without affecting blood flow, even if the dissection is located near important arterial branches that supply blood to vital organs.

Recovery from endovascular surgery is significantly quicker than that from open surgery. You can expect to remain in the hospital for two to three days after surgery. Because your aorta and heart need rest to heal, your doctor may recommend that you refrain from driving and lifting anything heavier than 10 pounds for 10 days after surgery.

Open Heart Surgery

Type A aortic dissections are located in the ascending aorta, the part that exits the heart. These typically require emergency surgery—as do dissections involving the arch that forms the top of the aorta—because the dissection can split open or “unzip” the aorta.

 

Bentalls Procedure:

This can cause bleeding into the pericardium, the sac-like membrane that envelops the heart, or into the abdomen. This bleeding can lead to cardiac tamponade, a potentially fatal condition in which the blood accumulating in the pericardium puts pressure on the heart, preventing it from working properly.

In open heart surgery, the surgeon makes a large incision in the chest and opens the sternum or breastbone, with surgical tools. Then he or she sutures or sews together, the “flap” which is the partition between the layers of the aortic wall created by the dissection.

Sections of the aorta are replaced with a synthetic material called Dacron®, which usually lasts a lifetime. Prior to the procedure, surgeons give you a nutrient-rich solution intravenously that safely slows the heart until it’s nearly stopped to allow for surgery.

Because open heart surgery is a complex procedure, it can lead to serious complications. You can expect to remain in the intensive care unit for several days after surgery. This allows your doctor to monitor you for signs of internal bleeding, heart attack, kidney failure, infection, and ischemia; a condition in which organs, such as the kidneys, are deprived of oxygen-rich blood.

Stents may also be implanted during open surgery to repair Type A aortic dissections.

After you return home, your doctor may advise you not to drive for 1 to 2 weeks and to avoid lifting anything heavier than 10 pounds for 4 to 6 weeks. This is because your aorta and heart require rest and time to heal.

You may have a CT scan or MRI scan after surgery to ensure that your aorta is healing properly. Your doctor may prescribe a medication called a beta blocker to control your blood pressure.

Left Ventricular Assist Device (LVAD) and Heart Transplantation

A left ventricular assist device (VAD — also called ventricular assist system or VAS) is a type of mechanical circulatory support device (MCSD). It is a mechanical pump that is implanted in patients who have heart failure to help the heart’s weakened left ventricle (major pumping chamber of the heart) pump blood throughout the body.

The LVAD Can Be Used Two Ways:

Bridge-to-transplant— which means it can help a patient survive until a donor heart becomes available for transplant. This option may be appropriate for people whose medical therapy has failed and who are hospitalized with end-stage systolic heart failure. As a bridge-to-transplant, the LVAD allows the patient to be discharged to an outpatient setting while waiting for transplant.

Destination therapy— an alternative to heart transplant. Destination therapy provides long-term support in patients who are not candidates for transplant.

The LVAD may provide blood pressure support; maintain or improve other organ function by improving blood flow to the kidneys, liver, brain and other organs; and when used as destination therapy or bridge-to-transplant, improve the patient’s strength and ability to participate in activities such as cardiac rehabilitation; and allow the patient to be discharged from the hospital.

How Does LVAD Work?

A LVAD does not replace the heart.  The Left Ventricular Assist Device (LVAD) receives blood from the left ventricle and delivers it to the aorta. It assists the patient’s own heart to pump blood throughout the body, decreasing the work of the left ventricle.

Components of VAD

There are a few different types of LVADs available. The type of VAD selected will depend on each patient’s individual needs and medical condition. The components of the VAD vary, according to the specific device used. In general, the device consists of an implanted pump unit, a controller, and an energy or power supply.

Candidates For LVAD:

An LVAD is a treatment option for certain patients with end-stage heart failure. Your doctor will determine if a VAD is an appropriate treatment for you, based on your medical condition, symptoms, age, body size and presence of other medical conditions.

An LVAD may not be the appropriate treatment choice for some patients who have blood clotting disorders, irreversible kidney failure, severe liver disease, severe lung disease, or infections that cannot be treated with antibiotics.

Risks of the LVAD implantation procedure:

As with any surgical procedure, there are risks to the VAD implantation procedure. Some of the possible risks include bleeding, development of blood clots, respiratory failure, kidney failure, stroke, infection and device failure. Special precautions are taken to decrease these risks.

Extracorporeal Membrane Oxygenation (ECMO)

Max Healthcare is one of the pioneer hospitals in providing ECMO services for whole of Northern India.

What Is ECMO:

Extracorporeal Membrane Oxygenation or ECMO, is a treatment used for patients with life-threatening heart and/or lung problems. It provides long-term breathing and heart support and is used only when all of the standard treatments for those problems have already been tried. ECMO can support patients for days to weeks while doctors treat their underlying illness.

What Does ECMO Stand For?

Extracorporeal: outside the body

Membrane: a type of artificial lung

Oxygenation: the process of getting oxygen into the blood

ECMO is performed using a heart-lung bypass machine similar to the one used during open heart surgery. The ECMO machine, often referred to as a “circuit”, is quite large and contains sterile plastic tubing that moves blood from your baby to the “ECMO lung” and then back to your child. The ECMO lung adds oxygen to the blood and removes carbon dioxide, as a healthy lung would.

There are two types of ECMO. Venovenous (V-V) ECMO is used when the heart is functioning well and only the lungs need to rest and heal. Venoarterial (V-A) ECMO is used when the heart as well as the lungs need to rest and heal.