Thoracic endovascular aortic repair under venovenous extracorporeal membrane oxygenation support in a patient with refractory pneumothorax

Abstract

Intraoperative positive pressure ventilation may cause a pneumothorax in patients with pulmonary emphysema, resulting in intraoperative hypoxic events. Here we report a case of thoracic endovascular aortic repair (TEVAR) under veno- venous extracorporeal membrane oxygenation (vvECMO) support. A 76-year-old man was diagnosed with a distal aortic arch aneurysm. He also had a pulmonary emphysema complicated with refractory pneumothorax. After endotracheal bronchial embolization, TEVAR was performed under general anesthesia with endotracheal intubation. To prevent intraoperative hypoxic events, vvECMO was employed during the stent-graft implantation. This technique may be useful for safely performing TEVAR in patients with pulmonary emphysema.