VENOVENOUS EXTRACORPOREAL LUNG ASSIST WITH CONCURRENT DISTAL AORTIC PERFUSION - REPAIR OF RUPTURED AORTA IN A PATIENT WITH DENSE ARDS

Extracorporeal lung assist (ECLA) allowed surgical repair of a rupture d descending thoracic aorta to be performed in a patient with profound respiratory failure. Dense acute respiratory distress syndrome (ARDS) developed during his 15-day hospitalization at a regional trauma cent er. After transfer to a Level 1 facility, an additional injury was dia gnosed: traumatic rupture of the aorta, contained within a pseudoaneur ysm. ECLA by the veno-venous route was required immediately preoperati vely and distal aortic perfusion was performed during the aortic repai r. Despite deflation of the left lung, the patient was oxygenated and ventilated adequately during surgery. Cross-clamp time was 48 minutes. The patient was weaned from ECLA by the fifth postoperative day. To o ur knowledge, this is the first report of concurrent veno-venous pulmo nary support with distal aortic perfusion.