Abstract

Veno-Arterial extracorporeal mechanical oxygenation (VA ECMO) provides temporary mechanical support to the patient with cardiac and/or respiratory failure in cases of cardiogenic shock or heart failure. VA ECMO requires systemic anticoagulation to prevent thrombosis in the oxygenator and circuit. We describe the unique case of a previously healthy young woman who suffered an acute coronary dissection and subsequent cardiogenic shock. Emergent placement on VA ECMO and systemic anticoagulation unmasked a bleeding colonic cancer which required urgent resection. Unfortunately, the ultimate prognosis in ECMO patients requiring noncardiac surgery is poor and there is a high risk of perioperative complications and even death.

Keywords: Heart failure; Anticoagulation; Isoflurane; Fibrinogen; Heparin; Anesthetics