Introduction: The discontinuation of venoarterial extracorporeal membrane oxygenation (VA ECMO) is a critical step in patient recovery. To reduce risks, weaning trials must be performed to buttress this important decision. However, a successful weaning trial does not preclude the possibility of complications. Case report: Here, we report a case of sudden multiple organ failure in a heart transplant patient, occurring after a successful ECMO weaning trial. We finally diagnosed a rare post-surgical complication of bicaval orthotopic heart transplantation, a severe stenosis of the inferior vena cava (IVC) that had been masked by the post-operative ECMO. Discussion and conclusion: Our case report should serve as a cautionary tale: it may be of interest to add a search for complications at the vascular anastomoses to the weaning trial procedure and to keep an eye out for them in the following days.
Heart transplant after profoundly extended ambulatory central venoarterial extracorporeal membrane oxygenation