Peripheral VA-ECMO with direct biventricular decompression for refractory cardiogenic shock

Perfusion. 2018 Sep;33(6):493-495. doi: 10.1177/0267659118761558. Epub 2018 Feb 21.

Abstract

Cardiogenic shock and cardiac arrest are life-threatening emergencies that result in high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via peripheral cannulation is an option for patients who do not respond to conventional therapies. Left ventricular (LV) distention is a major limitation with peripheral VA-ECMO and is thought to contribute to poor recovery and the inability to wean off VA-ECMO. We report on a novel technique that combines peripheral VA-ECMO with off-pump insertion of a trans-apical LV venting cannula and a right ventricular decompression cannula.

Trial registration: ClinicalTrials.gov NCT02326402.

Keywords: VA-ECMO; cardiac arrest; cardiogenic shock; mechanical circulatory support; ventricular assist device.

Publication types

  • Case Reports
  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Catheterization / instrumentation
  • Catheterization / methods
  • Decompression, Surgical / instrumentation
  • Decompression, Surgical / methods*
  • Extracorporeal Membrane Oxygenation / instrumentation
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery*
  • Hemodynamics
  • Humans
  • Shock, Cardiogenic / physiopathology
  • Shock, Cardiogenic / surgery*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02326402