Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation Case Series: A Single-Center Experience

Rebecca Phillip, Jordan Howard, Hussam Hawamdeh, Thomas Tribble, John Gurley, Sibu Saha

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: We aimed to review the characteristics and outcomes of left atrial veno-arterial extra corporeal membrane oxygenation (LAVA ECMO) at our institution over a 4-y period from 2017 to 2020. Methods: Among 227 adult patients who received VA ECMO support from January 2017 to December 2020, we reviewed 33 of these who underwent transseptal cannulation and were converted to LAVA ECMO. The timing of transseptal cannulation, either at initiation of VA ECMO (n = 25) or with a later transseptal cannulation to treat complications of left ventricular (LV) distention while on VA ECMO (n = 8), was reviewed. The clinical characteristics, indications, echocardiography data, and outcomes were assessed. Results: Duration of LAVA ECMO support ranged from 1 to 13 d, with a median of 5 d. Successful weaning from the LAVA ECMO circuit was achieved for 15 patients (45%). The in-hospital mortality rate was 66%. There were 11 patients (33%) who survived to be discharged from the hospital. Conclusions: LV distention is a known complication of VA ECMO and impedes the recovery of the heart. LAVA ECMO provides a novel approach to treating LV distention. Additionally, our review shows that this modality may be used as a bridge to durable mechanical circulatory support, cardiac transplantation, or recovery.

Original languageEnglish
Pages (from-to)238-244
Number of pages7
JournalJournal of Surgical Research
Volume281
DOIs
StatePublished - Jan 2023

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.

Keywords

  • Extracorporeal membrane oxygenation
  • Left ventricular venting
  • Pulmonary edema
  • Transseptal canula

ASJC Scopus subject areas

  • Surgery

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