Left ventricular unloading during veno-arterial ECMO: a review of percutaneous and surgical unloading interventions

Dirk W. Donker, Daniel Brodie, José P.S. Henriques, Michael Broomé*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Short-term mechanical support by veno-arterial extracorporeal membrane oxygenation (VA ECMO) is more and more applied in patients with severe cardiogenic shock. A major shortcoming of VA ECMO is its variable, but inherent increase of left ventricular (LV) mechanical load, which may aggravate pulmonary edema and hamper cardiac recovery. In order to mitigate these negative sequelae of VA ECMO, different adjunct LV unloading interventions have gained a broad interest in recent years. Here, we review the whole spectrum of percutaneous and surgical techniques combined with VA ECMO reported to date.

Original languageEnglish
Pages (from-to)98-105
Number of pages8
JournalPerfusion
Volume34
Issue number2
Early online date16 Aug 2018
DOIs
Publication statusPublished - Mar 2019

Keywords

  • cardiogenic shock
  • cardiovascular modeling
  • computer simulation
  • left ventricular unloading
  • veno-arterial extracorporeal membrane oxygenation (VA ECMO)
  • Extracorporeal Membrane Oxygenation/methods
  • Heart Ventricles/metabolism
  • Humans
  • Shock, Cardiogenic/therapy

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