Surgical aspects of pediatric cardiac extracorporeal membrane oxygenation

Because children with severe myocardial dysfunction have limited therapeuti c options, mechanical support of a failing heart is a matter of great inter est. Ln the setting of cardiogenic shock or severe low cardiac output and h ypoperfusion, extracorporeal membrane oxygenation (ECMO) can produce decisi ve improvements. The criteria for successful treatment include appropriate patient selection, improved surgical techniques and experience, higher reco gnition and anticipation of complications, and minimized delay in initiatio n of ECMO. Because the need for mechanical circulatory support may arise pr e-, intra-, and postoperatively, every pediatric cardiac surgeon must be fa miliar with the principles and the surgical aspects of ECMO.