Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO): Percutaneous Bi-Atrial Drainage to Avoid Pulmonary Edema in a Patient with Left Ventricular Systolic Dysfunction

Authors

Kenneth R. Dulnuan, Robert Wood Johnson University HospitalFollow
Joseph B. ZwischenbergerFollow
John G. Gurley, University of KentuckyFollow
Maya Guglin, Indiana UniversityFollow

Document Type

Case Report

Abstract

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used in patients with severe cardiogenic shock refractory to medical therapy. During V-A ECMO, retrograde flow in the aorta towards the left ventricle (LV) causes increased left-sided filling pressures, which may lead to pulmonary edema. Different strategies have been proposed to decompress the left heart, including placement of an intraaortic balloon pump (IABP), Impella® (Abiomed), or TandemHeart® (Cardiac Assist). Percutaneous decompression of the left atrium via placement of a transseptal cannula incorporated into the existing venous limb had also been previously done. We describe the novel use of the VFEM venous femoral cannula (Edwards Lifesciences) placed transseptally in a left atrial, veno-arterial (LAVA) configuration to provide simultaneous bi-atrial drainage in a patient on V-A ECMO due to cardiogenic shock.

Streaming Media

Creative Commons License

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

Recommended Citation

Dulnuan, Kenneth R.; Zwischenberger, Joseph B.; Gurley, John G.; and Guglin, Maya (2022) "Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO): Percutaneous Bi-Atrial Drainage to Avoid Pulmonary Edema in a Patient with Left Ventricular Systolic Dysfunction," The VAD Journal: Vol. 8(1) :e20228111 DOI: https://doi.org/10.11589/vad/e20228111

Available at: https://digitalcommons.library.tmc.edu/vad/vol8/iss1/11

First Page

e20228111