Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Strategy in Postcardiotomy Cardiogenic Shock: A Case Series

Authors

Daniel Manzur-Sandoval MD, Ignacio Chávez National Institute of CardiologyFollow
Gian Manuel Jiménez-Rodríguez MD, Ignacio Chávez National Institute of CardiologyFollow
José Luis Elizalde-Silva MD, Ignacio Chávez National Institute of CardiologyFollow
Meredith Fernanda Sánchez-Torres MD, Ignacio Chávez National Institute of CardiologyFollow
Uriel Encarnación-Martínez MD, Ignacio Chávez National Institute of CardiologyFollow
Cristhian Josué Gaytán-García MD, Ignacio Chávez National Institute of CardiologyFollow
José Octavio Salazar-Delgado MD, Ignacio Chávez National Institute of CardiologyFollow
Guadalupe Lisseth Hernández-González MD, Ignacio Chávez National Institute of CardiologyFollow
Gustavo Rojas-Velasco MD, Ignacio Chávez National Institute of CardiologyFollow

Document Type

Case Report

Abstract

Postcardiotomy cardiogenic shock is a rare complication with high mortality. When patients do not respond to the placement of an intra-aortic balloon pump or pharmacological treatment, therapy with peripheral venoarterial extracorporeal membrane is a viable option that allows active resuscitation. The adjunct use of Impella® (Abiomed, Danvers, MA, USA) allows active unloading of the dysfunctional left ventricle. However, left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) is an appealing and effective strategy in cases of aortic dissection, aortic valve replacement, or bioprosthesis of the aorta. Insertion of an extraction cannula that can discharge both atria or only the left atrium allows biventricular discharge or discharge of only the left ventricle, respectively. We present a case series of patients who underwent Bentall–De Bono surgery with severe aortic regurgitation secondary to aortic dissection and/or aneurysm. In one case, the aortic dissection extended before the bifurcation of the iliac arteries, and LAVA-ECMO was a safe treatment option. To our knowledge, this is the first published experience of LAVA-ECMO after cardiac surgery in this population.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Manzur-Sandoval, Daniel MD; Jiménez-Rodríguez, Gian Manuel MD; Elizalde-Silva, José Luis MD; Sánchez-Torres, Meredith Fernanda MD; Encarnación-Martínez, Uriel MD; Gaytán-García, Cristhian Josué MD; Salazar-Delgado, José Octavio MD; Hernández-González, Guadalupe Lisseth MD; and Rojas-Velasco, Gustavo MD (2024) "Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Strategy in Postcardiotomy Cardiogenic Shock: A Case Series," The VAD Journal: Vol. 10(1) :e20241016 DOI: https://doi.org/10.58464/2378-2706.1065

Available at: https://digitalcommons.library.tmc.edu/vad/vol10/iss1/6

First Page

e20241016