Successful management of pulmonary hemorrhage from lung carcinoid, in a patient on VenoArterial extracorporeal membrane oxygenation support

IntroductionA young man was referred to our Center for refractory cardiogenic shock, accompanied with uncontrolled atrial flutter of unknown duration. The patient was supported with VenoArterial Extracorporeal Membrane Oxygenation (VA ECMO) and Intra-Aortic Balloon Pump (IABP) as a bridge to decision.Case ReportHis course was complicated by pulmonary hemorrhage due to an unknown endobronchial mass. A low-grade typical carcinoid without metastases was revealed during work up. He was treated successfully with bronchoscopy-guided interventional therapies and cavo-tricuspid isthmus ablation. Mechanical support was successfully weaned off and 3 months after discharge, he was asymptomatic with no sign of residual tumor.DiscussionEndobronchial treatment is a parenchyma-preserving alternative to surgery, with a comparable recurrence rate, especially in patients with typical carcinoid.ConclusionThis is the first case report describing the successful management of pulmonary hemorrhage due to lung carcinoid, in a patient supported with VA ECMO for cardiogenic shock.