Related Experiment Video
Updated: Aug 23, 2026
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Percutaneous bridge to heart transplantation by venoarterial ECMO and transaortic left ventricular venting
R Fumagalli1, M Bombino, M Borelli
1Department of Anesthesia and Critical Care, Ospedale S. Gerardo Monza, Monza, Università degli Studi Milano-Bicocca, Italy. rfumagalli@ospedaliriuniti.bergamo.it
Insights
This case study shows nonpulsatile venoarterial bypass with left ventricular decompression effectively supported a patient with cardiogenic shock, enabling successful heart transplantation.
Area of Science:
- Cardiovascular Surgery
- Mechanical Circulatory Support
- Transplantation Medicine
Background:
- Cardiogenic shock necessitates advanced mechanical circulatory support.
- Effective left ventricular unloading is crucial for managing cardiogenic shock.
- Venoarterial bypass is a common support strategy, but left ventricular unloading requires specific techniques.
Observation:
- A novel approach combined nonpulsatile venoarterial bypass with percutaneous left ventricular decompression via an intraventricular catheter.
- Blood was drained from the left ventricle and pumped into the femoral artery.
- This technique aimed to reduce left heart filling pressures and improve cardiac output.
Findings:
- The combined support strategy successfully managed cardiogenic shock.
- Left ventricular decompression normalized left heart filling pressures.
- Pulmonary edema resolved, and the patient was stabilized for heart transplantation.
Implications:
- This case demonstrates a potentially effective method for mechanical cardiocirculatory support in severe cardiogenic shock.
- Percutaneous left ventricular decompression offers a less invasive option for unloading the left ventricle during bypass.
- This approach may improve outcomes for patients awaiting or undergoing heart transplantation.
Abstract:
We report a case in which life support for cardiogenic shock was achieved by a nonpulsatile venoarterial bypass, and left ventricular decompression was obtained by a catheter placed percutaneously through the aortic valve into the left ventricle. The blood drained from the left ventricle was pumped into the femoral artery. The normalization of left heart filling pressures allowed the resolution of pulmonary edema, and the patient underwent a successful heart transplantation following 7 days of mechanical cardiocirculatory support.
