Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO): Percutaneous Bi-Atrial Drainage to Avoid Pulmonary Edema in a Patient with Left Ventricular Systolic Dysfunction

Kenneth R. Dulnuan, Joseph B. Zwischenberger, John G. Gurley & Maya Guglin
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used in patients with severe cardiogenic shock refractory to medical therapy. During V-A ECMO, retrograde flow in the aorta towards the left ventricle (LV) causes increased left-sided filling pressures, which may lead to pulmonary edema. Different strategies have been proposed to decompress the left heart, including placement of an intraaortic balloon pump (IABP), Impella® (Abiomed), or TandemHeart® (Cardiac Assist).1-3 Percutaneous decompression of the left atrium via placement of...
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