PMID- 34934901
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 5
IP  - 12
DP  - 2021 Dec
TI  - Spinal cord infarction and peripheral extracorporeal membrane oxygenation: a case 
      series.
PG  - ytab488
LID - 10.1093/ehjcr/ytab488 [doi]
LID - ytab488
AB  - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is 
      increasingly utilized in patients with cardiogenic shock due to improved 
      technology and outcomes. Peripheral VA ECMO offers several advantages over 
      central ECMO and is becoming increasingly popular. However, when configured via 
      the femoral vessels, retrograde flow to the descending aorta and arch of aorta 
      competes with antegrade ventricular output and can be associated with a watershed 
      phenomenon and increased risk of neurologic and visceral injury. CASE SUMMARY: In 
      this case series, we report three patients who were supported with peripheral VA 
      ECMO for cardiogenic shock. All three were successfully weaned from peripheral VA 
      ECMO; however, they had developed bilateral lower limb paralysis. Magnetic 
      resonance imaging revealed spinal cord infarction in all three patients. All 
      patients subsequently succumbed to multiorgan failure and did not survive to 
      hospital discharge. DISCUSSION: The use of mechanical circulatory support, in 
      particular, peripheral ECMO, has escalated with advances in technology, better 
      understanding of cardiac physiology and improving outcomes. Spinal cord 
      infarction is a rare but serious complication of peripheral VA ECMO support with 
      only a few case reports published. Further studies are needed to identify the 
      exact cause and prevention of this rare but often terminal complication. Through 
      this series of three patients supported on peripheral VA ECMO complicated by 
      spinal cord infarction, we review previously published reports, analyse possible 
      mechanisms, and propose alternate management strategies to be considered in 
      patients at risk.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Gangahanumaiah, Shivanand
AU  - Gangahanumaiah S
AUID- ORCID: 0000-0003-4258-4908
AD  - Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne 3004, 
      Australia.
FAU - Zhu, Michael
AU  - Zhu M
AUID- ORCID: 0000-0003-4724-008X
AD  - Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne 3004, 
      Australia.
FAU - Summerhayes, Robyn
AU  - Summerhayes R
AUID- ORCID: 0000-0003-1372-3411
AD  - Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne 3004, 
      Australia.
FAU - Marasco, Silvana F
AU  - Marasco SF
AUID- ORCID: 0000-0001-7826-0986
AD  - Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne 3004, 
      Australia.
AD  - Department of Surgery, Monash University, Melbourne 3004, Australia.
LA  - eng
PT  - Case Reports
DEP - 20211211
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC8684805
OTO - NOTNLM
OT  - Case report
OT  - Spinal cord infarction
OT  - Veno-arterial extracorporeal membrane oxygenation
EDAT- 2021/12/23 06:00
MHDA- 2021/12/23 06:01
PMCR- 2021/12/11
CRDT- 2021/12/22 06:53
PHST- 2021/07/13 00:00 [received]
PHST- 2021/08/24 00:00 [revised]
PHST- 2021/11/25 00:00 [accepted]
PHST- 2021/12/22 06:53 [entrez]
PHST- 2021/12/23 06:00 [pubmed]
PHST- 2021/12/23 06:01 [medline]
PHST- 2021/12/11 00:00 [pmc-release]
AID - ytab488 [pii]
AID - 10.1093/ehjcr/ytab488 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2021 Dec 11;5(12):ytab488. doi: 10.1093/ehjcr/ytab488. 
      eCollection 2021 Dec.