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Case report
Postcardiotomy extracorporeal membrane oxygenation in a patient with Austrian syndrome
  1. Joy C Edlin1,
  2. Amr Metwalli1,
  3. Simon J Finney2 and
  4. Shirish G Ambekar1
  1. 1Department of Cardiac Surgery, St Bartholomew's Hospital, London, UK
  2. 2Department of Peri-Operative Medicine, St Bartholomew's Hospital, London, UK
  1. Correspondence to Ms Joy C Edlin; joy.edlin{at}


A 43-year-old man with Austrian syndrome, the triad of infective endocarditis (IE), pneumonia and meningitis caused by Streptococcus pneumoniae, underwent emergency aortic and mitral valve replacement and closure of an aortic root abscess. Postoperatively, he required mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation and an intra-aortic balloon pump. Several days after surgery, new mitral and aortic paraprosthetic leaks (PPLs) developed. These were managed conservatively, initially, but eventually required percutaneous closure 6 weeks after the initial operation. This has enabled the patient to recover to independent mobility, 20 weeks after the operation. This case illustrates a rare clinical syndrome and the devastating impact of IE. Moreover, it illustrates the successful application of extracorporeal membrane oxygenation in postcardiotomy cardiac failure and the successful treatment of PPL in a patient unfit for redo surgery.

  • valvar diseases
  • infections
  • adult intensive care
  • heart failure
  • interventional cardiology
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  • Contributors JCE wrote the case report, edited the article and edited the figures. She also contacted the patient and arranged patient consent. AM acquired the patient data from the electronic patient notes and edited the article. SJF and SGA both conceived of the case report and ensured the salient points were covered, as well as edited the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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