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A case report of unexpected right-to-left shunt under mechanical support for post-infarction ventricular septal defect: evaluation with haemodynamic simulator.

Arudo HiraokaKeita SakuTakuya NishikawaKenji Sunagawa
Published in: European heart journal. Case reports (2021)
ECPELLA (ECMO + Impella) can offset the adverse effects of isolated ECMO support and reduce the PIVSD shunt flow. However, the risk of right-to-left shunt has not been reported, and ECPELLA caused a right-to-left shunt with deoxygenated systemic perfusion in the present case. A simulation study indicated that the right ventricular failure in PIVSD may pose a risk for right-to-left PIVSD shunt under Impella support.
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