Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report.
Gian Manuel Jiménez-RodríguezGustavo Rojas-VelascoEduardo A Arias-SánchezDaniel Manzur-SandovalNorman Said Vega-ServinRicardo-Eduardo Quirazco-CordovaGuering Eid-LidtPublished in: European heart journal. Case reports (2023)
The choice of mechanical support can be difficult in this type of patient. Given the risk of an increased shunt because of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the increase in left ventricle (LV) afterload, several measures were taken to plan the best ECMO configuration. Given the absence of any real improvement in the LV and an elevated residual ratio between pulmonary and systemic flow (Qp/Qs), the final decision was to switch to left atrial VA-ECMO (LAVA-ECMO). The use of LAVA-ECMO improved the patient's haemodynamics and allowed his condition to stabilize; LAVA-ECMO is feasible and may be effective as a mechanical circulatory support (MCS) strategy for patients in cardiogenic shock due to VSD as a mechanical complication of acute MI.
Keyphrases
- extracorporeal membrane oxygenation
- left atrial
- acute respiratory distress syndrome
- respiratory failure
- left ventricular
- mitral valve
- atrial fibrillation
- catheter ablation
- heart failure
- case report
- pulmonary hypertension
- end stage renal disease
- mechanical ventilation
- pulmonary artery
- ejection fraction
- newly diagnosed
- peritoneal dialysis
- coronary artery
- hepatitis b virus
- prognostic factors
- decision making
- drug induced
- aortic dissection