Related Experiment Video
Updated: Aug 13, 2026
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Ventricular unloading with a miniature axial flow pump in combination with extracorporeal membrane oxygenation
Dirk Vlasselaers1, Matthias Desmet2, Lars Desmet2
1Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. dirk.vlasselaers@uz.kuleuven.ac.be.
Objective:
ECMO for acute cardiorespiratory failure is an established therapeutic option. Persistent insufficient unloading of the left ventricle (LV) can compromise recovery of ventricular function. We decided to insert a miniature rotary blood pump (Impella) for decompression of the LV. In contrast to previous experience with this new device, where it was generally used for postcardiotomy heart failure or cardiogenic shock and inserted in the operating room or the catheter laboratory, this is the first report describing the potential of this technology in the intensive care unit, in a patient on ECMO and the value of echocardiography guidance.
Patient:
A 13-year-old boy with a history of congenital heart disease was admitted to the ICU with acute cardio-respiratory failure.
Interventions:
On day 2 venoarterial ECMO was instituted because of worsening cardiorespiratory insufficiency refractory to conventional treatment. On day 5 a percutaneous rotary blood pump was inserted to decompress the LV.
Conclusions:
A percutaneous miniature rotary blood pump can be an alternative to decompress a failing LV in the setting of VA-ECMO. Echocardiography can avoid the use of fluoroscopy and the transport to a catheter laboratory to insert the rotary pump.
