AUTHOR=Tschöpe Carsten , Alogna Alessio , Faragli Alessandro , Klingel Karin , Schmidt Gunther , Heilmann Torsten Wolfgang , B. Bastos Marcelo , Spillmann Frank 

TITLE=Case Report First-in-Man Method Description: Left Ventricular Unloading With iVAC2L During Veno-Arterial Extracorporeal Membrane Oxygenation: From Veno-Arterial Extracorporeal Membrane Oxygenation to ECMELLA to EC-iVAC®

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 7 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2020.563448

DOI=10.3389/fcvm.2020.563448

ISSN=2297-055X

ABSTRACT=Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is increasingly used in cardiogenic shock patients with bi-ventricular failure to maintain systemic perfusion. However, the increase in afterload and the overload of left ventricle (LV) are major drawbacks of V-A ECMO. To avoid these negative effects, an additional LV venting strategy with an Impella CP (3.5 L/min cardiac output support) was used in a patient with cardiogenic shock and severe acute myocarditis (ECMELLA- approach). After a hemolysis crisis, the Impella® device has been substituted with an iVAC 2L® catheter to obtain LV unloading with pulsatile flow. An improvement in LVEF and LVEDD together with a reduction of free hemoglobin have been observed, showing a potential application of iVAC 2L in patients with cardiogenic shock and increased hemolysis.