Perioperative Extra Corporeal Membrane Oxygenation in Neonates With Transposition of the Great Arteries: 15 Years of Experience

This retrospective cohort study investigated the use of extracorporeal membrane oxygenation (ECMO) in neonates with transposition of the great arteries at a single center from 2009 to 2024. A total of 22 neonates received ECMO, with a median age at initiation of 6.5 days. Of these, 12 underwent preoperative ECMO for issues such as severe pulmonary hypertension or respiratory failure, while 11 received it postoperatively due to failure to wean from cardiopulmonary bypass, low cardiac output, or cardiac arrest. The overall median ECMO duration was 75 hours, with a survival rate of 59 percent to hospital discharge. In the preoperative ECMO group, 42 percent died (four before surgery and one postoperatively while still on ECMO), whereas the postoperative group had a survival rate of 60 percent. This study highlights the role of ECMO as a bridge to recovery in TGA patients, demonstrating similar survival rates for preoperative and postoperative ECMO support.