PMID- 34466171
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210903
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 24
IP  - 3
DP  - 2021 Sep
TI  - Hemodynamic variations and pitfalls during venoarterial extracorporeal membrane 
      oxygenation and left ventricular apical unloading as bridge to heart 
      transplantation.
PG  - 106-109
LID - 10.1016/j.jccase.2021.02.008 [doi]
AB  - Despite the exponential increase in venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) use during the past decade, adult cardiac ECMO is still 
      accompanied by a high mortality rate. Moreover, although left ventricular 
      distension is now a well-known drawback of VA-ECMO, there seems to be great 
      variability in the hemodynamic management strategies and in the results reported 
      among the various centers. Hemodynamic management of VA-ECMO can be even more 
      challenging when complex configurations are deployed. Here we present and discuss 
      an interesting case of a modified VA-ECMO that although it occurred a few years 
      ago it is instructive for its hemodynamic implications and pitfalls. VA-ECMO can 
      either save the patient or catalyze the deterioration of a compromised clinical 
      condition and thus a close multiparametric monitoring is mandatory especially 
      with complex ECMO arrangements. A thorough understanding of the hemodynamic 
      changes and problems that may occur during these cases is necessary too. 
      Ultimately, critical thinking along with a proactive approach for early referral 
      to more specialized centers and immediate unloading of the left ventricle 
      whenever it is deemed necessary, together may contribute to reduce the relatively 
      high mortality rate with this type of support. <Learning objective: Venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) can either save the patient or 
      catalyze the deterioration of a compromised clinical condition if support-related 
      drawbacks are not correctly identified and promptly adjusted. Management of 
      complex VA-ECMO configurations can be challenging and thus a thorough 
      understanding and close multiparametric monitoring of the hemodynamic 
      implications and pitfalls are necessary in order to prevent negative outcomes.>.
CI  - (c) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights 
      reserved.
FAU - Tsioulpas, Charilaos
AU  - Tsioulpas C
AD  - Cardiothoracic and Vascular Department, Cardiac Surgery Unit, University Hospital 
      of Siena, Siena, Italy.
FAU - Mandoli, Giulia Elena
AU  - Mandoli GE
AD  - Department of Medical Biotechnologies, Division of Cardiology, University 
      Hospital of Siena, Siena, Italy.
FAU - Cameli, Matteo
AU  - Cameli M
AD  - Department of Medical Biotechnologies, Division of Cardiology, University 
      Hospital of Siena, Siena, Italy.
FAU - Bernazzali, Sonia
AU  - Bernazzali S
AD  - Cardiothoracic and Vascular Department, Cardiac Surgery Unit, University Hospital 
      of Siena, Siena, Italy.
FAU - Pastore, Maria Concetta
AU  - Pastore MC
AD  - Department of Medical Biotechnologies, Division of Cardiology, University 
      Hospital of Siena, Siena, Italy.
FAU - Simeone, Felicetta
AU  - Simeone F
AD  - Cardiothoracic and Vascular Department, Anaesthesiology and Cardiothoracic 
      Intensive Care Unit, University Hospital of Siena, Siena, Italy.
FAU - Valente, Serafina
AU  - Valente S
AD  - Department of Medical Biotechnologies, Division of Cardiology, University 
      Hospital of Siena, Siena, Italy.
FAU - Maccherini, Massimo
AU  - Maccherini M
AD  - Cardiothoracic and Vascular Department, Cardiac Surgery Unit, University Hospital 
      of Siena, Siena, Italy.
LA  - eng
PT  - Case Reports
DEP - 20210304
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC8380941
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Extracorporeal membrane oxygenation
OT  - Hemodynamics
OT  - Left ventricular unloading
OT  - Mechanical circulatory support
COIS- The authors declare that there are no conflicts of interest.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/02 06:01
PMCR- 2021/03/04
CRDT- 2021/09/01 07:23
PHST- 2020/11/25 00:00 [received]
PHST- 2021/01/21 00:00 [revised]
PHST- 2021/02/13 00:00 [accepted]
PHST- 2021/09/01 07:23 [entrez]
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2021/09/02 06:01 [medline]
PHST- 2021/03/04 00:00 [pmc-release]
AID - S1878-5409(21)00021-9 [pii]
AID - 10.1016/j.jccase.2021.02.008 [doi]
PST - epublish
SO  - J Cardiol Cases. 2021 Mar 4;24(3):106-109. doi: 10.1016/j.jccase.2021.02.008. 
      eCollection 2021 Sep.