The Use of Cardiopulmonary Bypass and Extracorporeal Membrane Oxygenation for Support During Removal of Two Teratomas and Hydrops Fetalis

Children’s Hospital of Pittsburgh, Department of Cardiothoracic Surgery, Pittsburgh, Pennsylvania

^* Address correspondence to: Leighann Burdis, BS, CCP, 3705 Fifth Avenue, One Children’s Place, Pittsburgh, PA 15213. E-mail: burdla@chp.edu

Abstract

The removal of massive tissue tumors often leads to rapid blood loss and decreased lung compliance because of large volume shifts. Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) have both been used as a means of support during resection of saccrococcygeal teratomas (1). Hydrops fetalis is the accumulation of fluid in extravascular spaces and body cavities. This leads to edema and sometimes hypoxia. ECMO has been used for support during treatment of hydrops fetalis (2). This patient was diagnosed, via sonogram, at 30 weeks gestation to have two teratomas and hydrops fetalis. Because of the risk of hemorrhage and poor lung compliance during removal of these types of tumors, CPB and ECMO were used. This support allowed for successful removal of the tumors. Following removal of the tumors, the patient failed to wean from CPB because of the severity of hydrops. The patient remained on extracorporeal support for treatment of hydrops fetalis. This report describes the perfusion techniques used for support during the removal of teratomas and the treatment of hydrops fetalis.