Abstract
Three cases of severe tracheal stenoses were treated using extracorporeal membrane oxygenation with a veno-venous bypass (V-V ECMO). Case 1 was a 78-year-old male admitted for severe dyspnea due to stenotic trachea with primary lung cancer invasion. Immediately, left pneumonectomy was carried out by V-V ECMO using a circuit of percutaneous cardiopulmonary support system (PCPS). Case 2 was a 57-year-old female admitted for dyspnea due to severe tracheal stenosis 3 mm in diameter by tracheal tuberculosis. Immediately, an expanding metallic stent was inserted to the trachea using V-V ECMO. In spite of the lack of lung ventilation for 20 minutes during the treatment, the oxygen saturation of arterial blood was maintained at 100%, and hemodynamics was stable. The trachea was dilated after placement of the stent, and the symptom resolved. Case 3 was a 74-year-old male admitted for dyspnea due to severe tracheal stenosis by esophageal cancer invasion. Dumon stent was inserted to the trachea using V-V ECMO, the trachea was dilated after placement of the stent, and the symptom resolved. These three cases had no complications during or after these treatments. These results indicated that V-V ECMO using PCPS was a very useful, powerful and satisfactory method in the treatment of tracheal stenosis during the lack of lung ventilation.
