Left atrial venous arterial extracorporeal membrane oxygenation for biventricular failure in cardiogenic shock

Abstract Background Cardiogenic shock complicated by biventricular (BIV) heart failure is associated with high mortality. Venous-arterial extra-corporeal membrane oxygenation limited the increase of left ventricular (LV) afterload. Complex configurations paired circulatory support devices have been used mixed results due to vascular access complications. One way simply place a transseptal cannula under echocardiographic guidance long fenestrated segment enabling simultaneous and right sided unloading known as left-atrial venous arterial (LAVA) ECMO. Purpose We aimed review safety outcomes LAVA ECMO utilized for at our institution. Methods Retrospective analysis Hospital Cath Lab Database yielded 6 patients undergoing LAVA-ECMO from 7/2020–3/2021. Patient characteristics, procedural data were analyzed. Variables are either expressed proportions or medians (Interquartile range; IQR). Results Median age was 55.5 years (IQR, 51–61) most men (83.3%). baseline LV ejection fraction 38% 23–56%) all had dysfunction. 4/6 (66.7%) severe valvular dysfunction including aortic regurgitation (2/6), mitral (2/6) stenosis (1/6). patient thrombus hemodynamics necessitated unloading. Intracardiac echocardiography guide puncture in 5/6 (83%). Transesophageal one case. Procedural hemodynamic variables outlined Tables 1 2 consecutively. case limb ischemia resulted an embolus contralateral limb. bridged 83% valve replacement, durable transplant (Table 1). Conclusions provides BIV single circuit successfully without direct Given safety, efficacy simplified configuration LAVA-ECMO, prospective studies indicated. Funding Acknowledgement Type funding sources: None.