Venovenous ECMO Support in an Infant With Single Ventricle Physiology and Catastrophic Pulmonary Venous Abnormalities

Extracorporeal membrane oxygenation (ECMO) is an accepted treatment modality for life support refractory to conventional efforts in neonates with complex congenital heart lesions. Cannulation for ECMO can be accomplished by venovenous (VV) access where patients receive primarily respiratory support or venoarterial (VA) access which provides complete cardiopulmonary support. VV ECMO delivered by a single-vessel cannulation with a dual-chamber venous cannula allows for respiratory support while the patient remains dependent upon intrinsic cardiac function to support hemodynamics. We present a case of support of a newborn with single ventricle physiology and intraparenchymal near-atresia of the pulmonary veins using VV ECMO.