Utilizing left atrial venoarterial extracorporeal membrane oxygenation to unload the left ventricle prior to angioplasty in acute myocardial infarction: a case series

Abstract

Abstract Background Left ventricular (LV) unloading prior to primary angioplasty in patients experiencing acute myocardial infarction holds promise for mitigating reperfusion injury and minimizing infarct size. Case summary This report delves into the utilization of left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) as a pre-percutaneous transluminal coronary angioplasty (PTCA) intervention strategy aimed at augmenting circulatory support while unloading the LV. Three cases of patients with ST elevation myocardial infarction involving the left ascending coronary artery who underwent LAVA-ECMO before primary PTCA are presented. Each patient maintained robust LV systolic function following weaning from ECMO support. Discussion These cases underscore the potential benefits of mechanical LV unloading prior to revascularization in reducing infarct size and mitigating the risk of post-myocardial infarction heart failure.