Cardiac catheterization and percutaneous intervention procedures on extracorporeal membrane oxygenation support

Abstract

Extracorporeal membrane oxygenation (ECMO) is used to support critically ill patients when conventional therapies have failed. ECMO has been available for four decades and has gained use as a rescue therapy in severe refractory hypoxic disorders and in patients with refractory cardiogenic shock (RCS). Over recent years, several percutaneous cardiac interventions and implant devices have been developed that are now used frequently in conjunction with ECMO in order to maintain organ perfusion. Here, we review the literature on VA-ECMO cannulation location, the use of VA-ECMO in interventions (e.g., coronary interventions and structural heart interventions) and percutaneous cardiac device implantation in VA-ECMO recipients with RCS.

Cardiac intensive care management of high-risk percutaneous coronary intervention using the venoarterial ECMO support

“…Conversely, oxygenated blood is returned via the arterial cannula (17-21 French) inserted in the femoral artery. The tip of the venous and arterial cannula end into the right atrium (RA) and in the iliac artery, respectively [6].…”

“…In this scenario, the term Bhigh-risk PCI( HR-PCI) has been recently coined to indicate a PCI performed providing short-term mechanical circulatory support (MCS) [4,5]. Among these procedures, a growing number of PCIs have been performed using the venoarterial extracorporeal membrane oxygenation (VA-ECMO), both during rescue intervention in acute myocardial infarction (AMI) or elective HR-PCI, to maintain an adequate organ perfusion and prevent further hemodynamic deteriorations [6]. Despite the widespread diffusion of cardiac care unit (CCU) and even more sophisticated antiischemic therapies, a small, but not neglectable proportion of All the authors equally contributed to the manuscript.…”