Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may improve survival after cardiac arrest by providing cardiopulmonary support. However, VA-ECMO increases left ventricular (LV) afterload, which can promote progressive LV distension and often requires a secondary approach to reduce LV pressure and volume in patients with left heart failure. We report a case of biventricular unloading via biatrial cannulation in the presence of LV thrombus using a TandemHeart percutaneous trans-septal cannula for VA-ECMO in an adult patient with refractory ventricular fibrillation.
Keywords: ECMO/IABP/Tandem/Impella; cardiogenic; heart failure; mechanical circulatory support; shock; ventricular assist device.
© 2014 Wiley Periodicals, Inc.