Aim Extracorporeal membrane oxygenation (ECMO) support is used as rehabilitation or bridging treatment in many cardiac pathologies such as decreased cardiac functions, resistant arrhythmias, and postoperative residual congenital diseases. Cardiac catheterization plays a key role in identifying or treating pathology in patients who do not respond appropriately to ECMO treatment. Our study aimed to share the experiences of cardiac catheterization performed under ECMO support.

Material and Method Cardiac catheterization was performed on 16 of 264 patients under ECMO support in Hacettepe University pediatric intensive care unit between 01.04.2013 and 01.11.2023. In this study, we retrospectively analyzed the clinical and catheterization data of these 16 patients.

Results Nine (56%) of the sixteen patients were female, their median age was 99 (0–190) months, and their median body weight was 20.5 (3–73) kg. Plasma exchange therapy was applied to 2 (12%) patients and renal replacement therapy was applied to 8 (50%) patients. Veno-arterial ECMO support was preferred in 14 (87%) patients, the median ECMO support duration was 13 (3–69) days. While diagnostic cardiac catheterization was performed on 8 (50%) patients; Fistula-shunt closure was performed in 3 (19%) patients, balloon angioplasty in 2 (12%), mesenchymal stem cell application in 2 (12%), and ablation in 1 (6%) (table 1). The median time between the start of ECMO and catheterization was 4 (0–59) days. Cyanotic congenital heart disease was present in 10 (62%) of the patients, acyanotic congenital heart disease in 3 (18%), cardiomyopathy in 2 (12%), and arrhythmia in 1 (6%). Mortality in the study was 12(75%).

Conclusions Cardiac catheterization should be considered early in the diagnosis and treatment in case of prolonged ECMO duration and worsening of the patient‘s clinical condition in the treatment of congenital or acquired heart diseases.