Use veno-venous extra corporeal membrane oxygenation in elderly patients with post-cardiotomy hypoxia: the changing paradigm of respiratory support in adult respiratory distress syndrome

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for ARDS treatment after cardiac surgery has progressed remarkably in the last 20 years. However, one of the limitations of a successful recover is age, being a powerful predictor of mortality. In this case report we discuss a 78-year-old man who underwent aortic valve and aortic root replacement. The postoperative period was complicated by ARDS following aspiration pneumonia treated with VV-ECMO weaned after 6 days. At two-year follow up, the patient made an excellent recover, being the second oldest person to survive VV-ECMO following cardiac surgery in the world. In the literature there is no consensus regarding a specific age limit and results, in the use of ECMO in the elderly are scarce and inconsistent. We do not think advanced age is a contraindication to the use of ECMO.