ECMO has become a therapeutic modality for in- and out-of-hospital scenarios and is
also suitable as a bridging therapy until further decisions and interventions can
be made. Case report: A 27-year-old male patient with mechanical aortic valve prothesis
had a sudden cardiac arrest (SCA). ROSC had been achieved after more than 60 min of
CPR and eight DC shocks due to ventricular fibrillation (VF). The National Ambulance
Service unit transported the patient to our clinic for further treatment. Due to the
trauma and therapeutic INR, a CT scan was performed and ruled out bleeding. Echocardiography
described severely decreased left ventricular function. Coronary angiography was negative.
Due to the therapeutic refractory circulatory and respiratory failure against intensive
care, VA-ECMO implantation was indicated. After four days of ECMO treatment, the patient’s
circulation was stabilized without neurological deficit, and the functions of the
end organs were normalized. Cardiac MRI showed no exact etiology behind SCA. ICD was
implanted due to VF and SCA. The patient was discharged after 19 days of hospitalization.
Conclusion: This case report points out that the early application of mechanical circulatory
support could be an outcome-determinant therapeutic modality. Post-resuscitation care
includes cardiorespiratory stabilization, treatment of reversible causes of malignant
arrhythmia, and secondary prevention.
