ECMO in single ventricle heart disease

Abstract

Purpose of review Cardiac extracorporeal membrane oxygenation (ECMO) for single ventricle heart disease is a complex intervention applied to a heterogeneous population of children. In this review, we describe the variable single ventricle populations who may be supported with ECMO and highlight recent literature regarding outcomes, trends, and evolving strategies. Recent findings In the last decade, there has been a significant increase in the international volume of single ventricle cardiac ECMO, with an overall trend towards improved survival. Single ventricle ECMO has now been accepted as a viable modality in most international centers, with an overall survival approximating 45% in the modern era. Single ventricle cardiac disease, with or without the requirement for ECMO, has an important impact upon long-term health-related quality of life outcomes. Summary While survival is slightly lower for single ventricle ECMO than in children with biventricular physiology, the need for ECMO identifies a subset of single ventricle patients who are at increased risk for interstage mortality, adverse neurodevelopmental outcomes, and the early onset of advanced heart failure symptoms. Care for survivors after ECMO requires increased surveillance and risk assessment prior to future intervention.