Valerie Munguia-Bryan and Mario Bryan knew for months that one of their twin babies would be born with a devastating congenital defect. But they refused to give up hope.

The couple was referred to the U-M Health System by their hometown physician in Saginaw because of U-M’s expertise in repairing difficult congenital defects and for heart-lung support technology known as Extracorporeal Membrane Oxygenation, or ECMO, which is used to care for desperately ill patients. Doctors expected the couple’s baby would need to be placed on ECMO to be kept alive from birth and through surgery.

The couple’s son soon was to become the 2,000th U-M patient to be placed on ECMO.

ECMO was developed in the 1970s by U-M surgeon Robert Bartlett, now a professor emeritus. The technology — described by some of Bartlett’s colleagues as “extraordinary” — does the work of a patient’s failing heart and lungs for a period of weeks, sometimes months. That’s often long enough for the heart and lungs to rest and recover, increasing the patient’s chance of survival.

The technology has spread worldwide, with more than 40,000 cases treated and more than 24,000 lives saved. ECMO also has the extraordinary legacy of diminishing mortality in conditions where patients used to have no chance of survival.

Manuel and Victor Bryan were born Nov. 1, 2010, at C. S. Mott Children’s Hospital. Manuel was born healthy.

As expected, Victor’s lungs were so underdeveloped that he was placed on ECMO immediately following birth. The following day, he was taken to surgery to repair his prenatally diagnosed congenital diaphragmatic hernia — to fashion a new diaphragm and to return his stomach, liver and intestines out of the upper cavity of the chest, where they were pushing up against the heart and lungs. Infants born with a congenital diaphragmatic hernia often have respiratory problems, with the severity varying by case from mild to life-threatening. In Victor’s case, it was life-threatening, so much so that Victor had two runs with ECMO. He is now recovering from a second surgery to close his abdomen.

“He is a fighter,” says his mom Valerie, who chose Victor’s name after her eye was caught by a U-M poster invoking the school’s “Hail to the Victors” fight song. “He will be Victorious.”

Dr. Ronald Hirschl says that Victor would not be alive today were it not for ECMO technology.

“Victor had almost no diaphragm, he had small lungs, pulmonary hypertension, and blood was not going through his lungs … he needed the ECMO badly,” says Hirschl, surgeon-in-chief and section head of pediatric surgery at Mott Children’s Hospital and Victor’s surgeon. “He is a perfect example of a child who wouldn’t be here today were it not for ECMO.

As U-M’s 2000th patient to be placed on ECMO, Victor’s milestone is one that was watched closely by the team of doctors, researchers, nurses and administrators who run the ECMO program.

“Victor is a very special baby,” says Bartlett, who retired from clinical practice in 2005 but continues to run the large laboratory where ECMO was developed, now focused on perfecting the technology. “We can’t wait for him to join his brother Manny at home soon.”

Bartlett says the future of ECMO after this 2000th patient milestone is brighter than ever. His lab continues to work on the development of artificial organs and surfaces to replace plastic tubing currently used to eliminate the need for blood thinners, which remains one of the biggest drawbacks of ECMO technology.

That breakthrough is just a few short years away. “We are very close.”