Refractory left ventricular distension. Mean PA pressures >30. Nonpulsatile arterial line tracing. Aortic valve does not open. Decompress left ventricle. Open chest postcardiotomy. Insert LV vent. Closed chest cannulation. Transeptal left atrial decompression. Cerebral hypoxia. Femoral arterial ECMO infusion with severe respiratory failure.
Feb 10, 2016 · Before ECMO, the median mean arterial pressure (MAP) was 40 mmHg (interquartile range (IQR) 33–46), the median arterial lactate level was 7.8 mmol/L (IQR 6.3–16.3), and the median left ventricular ejection fraction was 42.5 % (IQR 23.5–50.0). Despite adequate fluid and vasopressor therapy, refractory shock proceeded.
ECMO as a bridge to durable LVAD therapy lv vent on ecmo Jonathan Haft, MD Department of Cardiac Surgery. University of Michigan. Systolic Heart Failure ... • Transthoracic LV vent • RSPV • LV apex • PA • Percutaneous atrial septostomy • TandemHeart drain • Impella as LV vent. Complications: Harlequin Syndrome
The indication to vent the LV was seen in 34 patients (21%) without describing a clear indication to vent the LV. Notably, Pappalardo et al. describe a significant survival benefit for patients who were vented with the IMPELLA on ECMO after applying a propensity score matching analysis.
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