Single arterial access technique for simultaneous dual mechanical circulatory support in cardiogenic shock

Author:

Fardman Alexander,Dranishnikov Nikolay,Nersesian Gaik,Falk Volkmar,Potapov Evgenij

Abstract

AbstractTemporary mechanical circulatory support is a treatment of choice for patients in severe cardiogenic shock. Combining veno-arterial extracorporeal life support (ECLS) with devices that enable left ventricular unloading emerges as a promising strategy to diminish detrimental effect of elevated left ventricular afterload and to improve survival. However, the need to establish multiple arterial access sites remains a major drawback of this approach due to a significant rate of vascular complications. We describe herein a case of a single arterial access for ECLS and intra-aortic balloon pump using axillary artery that may provide a simple, modular and flexible approach for escalation or de-escalation of mechanical circulatory support.

Funder

Charité - Universitätsmedizin Berlin

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Surgery,Pulmonary and Respiratory Medicine

Reference8 articles.

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2. Schrage B, Becher PM, Bernhardt A, et al. Left ventricular unloading is associated with lower mortality in patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation: results from an international, Multicenter Cohort Study. Circulation. 2020;142(22):2095–106.

3. Montagner M, Nersesian G, Eulert-Grehn JJ, Wert L, Kempfert J, Potapov E. Single arterial access ECMELLA: a new concept and step-by-step procedure. Multimed Man Cardiothorac Surg. 2021;21:2021.

4. Ott S, Lewin D, Nersesian G, et al. Improving survival in cardiogenic shock-A propensity score-matched analysis of the impact of an institutional allocation protocol to short-term mechanical circulatory support. Life (Basel). 2022;12(11):1931.

5. Schrage B, Sundermeyer J, Blankenberg S, et al. Timing of active left ventricular unloading in patients on venoarterial extracorporeal membrane oxygenation therapy. JACC Heart Fail. 2022;13:S2213–21.

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