PMID- 38181416
OWN - NLM
STAT- MEDLINE
DCOM- 20240501
LR  - 20240501
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 70
IP  - 5
DP  - 2024 May 1
TI  - Novel Left Ventricular Unloading Strategies in Patients on Peripheral 
      Venoarterial Extracorporeal Membrane Oxygenation Support.
PG  - 396-403
LID - 10.1097/MAT.0000000000002136 [doi]
AB  - The purpose of this study was to evaluate left ventricular (LV) unloading 
      strategies in patients supported with peripheral venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO). A retrospective review was conducted of all 
      consecutive patients requiring VA-ECMO support for any indication, who underwent 
      novel LV unloading strategies with either direct left atrial venoarterial (LAVA) 
      cannulation or pulmonary artery venoarterial (PAVA) venting, in comparison to 
      Impella and intra-aortic balloon pump (IABP). The primary outcome was successful 
      bridge to transplant, LV assist device, or myocardial recovery. Forty-six 
      patients (63% male, mean age 52.8 +/- 17.6 years) were included. Fourteen patients 
      (30%) underwent novel unloading with either LAVA or PAVA, 11 patients (24%) 
      underwent IABP placement, and 21 patients (46%) underwent Impella insertion. In 
      the novel LV unloading cohort, 10 patients (71%) survived to hospital discharge. 
      Four patients (29%) were weaned from ECMO and eight patients (57%) underwent 
      cardiac transplantation. Although a trend favoring cannula-based unloading for 
      the primary outcome was noted, the cohort was too small for statistical 
      significance (79% LAVA/PAVA, 57% Impella, 45% IABP; p = 0.21). However, 
      probability of survival was greater in the LAVA/PAVA cohort compared to Impella 
      and IABP ( p < 0.05). Thus, we demonstrate the efficacy of LA and PA cannulation 
      as an alternative LV unloading strategy for patients supported with peripheral 
      VA-ECMO.
CI  - Copyright (c) ASAIO 2024.
FAU - Inglis, Sara S
AU  - Inglis SS
AUID- ORCID: 0000-0003-3200-3575
AD  - From the Van Cleve Cardiac Regenerative Medicine Program, Department of 
      Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Rosenbaum, Andrew N
AU  - Rosenbaum AN
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Rizzo, Skylar A
AU  - Rizzo SA
AD  - From the Van Cleve Cardiac Regenerative Medicine Program, Department of 
      Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
AD  - Medical Scientist Training Program, Mayo Clinic Alix School of Medicine, 
      Rochester, Minnesota.
FAU - Anderson, Jason H
AU  - Anderson JH
AD  - Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Yalamuri, Suraj
AU  - Yalamuri S
AD  - Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, 
      Minnesota.
FAU - Spencer, Philip J
AU  - Spencer PJ
AD  - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
FAU - Villavicencio, Mauricio A
AU  - Villavicencio MA
AD  - Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
FAU - Behfar, Atta
AU  - Behfar A
AD  - From the Van Cleve Cardiac Regenerative Medicine Program, Department of 
      Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
LA  - eng
PT  - Journal Article
DEP - 20240102
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Male
MH  - Middle Aged
MH  - Female
MH  - Retrospective Studies
MH  - *Heart-Assist Devices
MH  - Adult
MH  - Aged
MH  - *Intra-Aortic Balloon Pumping/methods
MH  - Treatment Outcome
MH  - Heart Failure/therapy/physiopathology/surgery
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2024/01/05 18:41
MHDA- 2024/05/01 13:31
CRDT- 2024/01/05 17:13
PHST- 2024/05/01 13:31 [medline]
PHST- 2024/01/05 18:41 [pubmed]
PHST- 2024/01/05 17:13 [entrez]
AID - 00002480-990000000-00383 [pii]
AID - 10.1097/MAT.0000000000002136 [doi]
PST - ppublish
SO  - ASAIO J. 2024 May 1;70(5):396-403. doi: 10.1097/MAT.0000000000002136. Epub 2024 
      Jan 2.