Prolonged ECMO support in a pediatric patient with complex cardiac conditions during wartime in Kyiv, Ukraine.

Background: In the conflict-affected setting of Kyiv, Ukraine, managing complex medical interventions presents significant challenges, especially for critically ill pediatric patients. This case report describes the prolonged use of extracorporeal membrane oxygenation (ECMO) in a 12-year-old girl with severe congenital heart disease, including critical aortic stenosis and myocarditis. In the absence of a transplant system and with limited resources, alternative solutions were explored to balance the high risk of complications and maintain ECMO support over an extended period.