ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Postcardiotomy extracorporeal membrane oxygenation for infective endocarditis in a patient with intravenous drug use and COVID-19 infection: An ethical dilemma
Stephanie Jiang1, Zachariah Mansour2, Campbell David3, Payne Darrin1, El-Diasty Mohammad1
1Division of Cardiac Surgery, Kingston Health Sciences Centre, Kingston, Canada
2Critical Care Medicine, Kingston Health Sciences Centre, Kingston, Canada
3Ethicist, Kingston Health Sciences Centre, Kingston, Canada
DOI : 10.5606/tgkdc.dergisi.2022.22741
In this report, we present a case of native valve infective endocarditis due to active intravenous drug use in a 29-yearold female patient that presented during the peak of the coronavirus disease 2019 (COVID-19) pandemic. The patient underwent a complex cardiac surgical intervention with aortic valve replacement and mitral valve repair. Postcardiotomy extracorporeal membrane oxygenation (ECMO) support was required due to severe biventricular dysfunction. In this unprecedented situation, multiple ethical dilemmas arose at different stages in the management of this patient. These dilemmas stemmed from the lack of evidence supporting the use of postcardiotomy ECMO in patients with active intravenous drug use and the scarcity of resources due to the COVID-19 pandemic, resulting in pressure put on our healthcare system. In this case report, we present the decisions made by our team, taking into account both the patient"s best interests and the available resources. We hope this decision-making process will serve as a valuable learning experience for other teams and will act as an antecedent for similar situations in the future.
Keywords : COVID19, extracorporeal membrane oxygenation, infectious endocarditis, intravenous drug use, medical ethics
Viewed : 1985
Downloaded : 550