Temporary extracorporeal life support: single-centre experience with a new concept

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Critical Care Medicine

Background:

• Cardiogenic shock (CS) is a life-threatening condition requiring advanced circulatory support.
• Veno-arterial extracorporeal membrane oxygenation with a micro-axial flow pump (ECMELLA) is an emerging therapy for severe CS.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of a novel single-artery access ECMELLA setup.
• To assess the outcomes and complications associated with ECMELLA 2.0 (femoral) and 2.1 (jugular venous) cannulation.

Main Methods:

• Retrospective analysis of 67 consecutive CS patients treated with ECMELLA 2.0 or 2.1.
• Data collected on patient demographics, CS etiology, pre-procedural status, and support duration.

Main Results:

• The study included 67 CS patients (mean age 60.7 years, 84% male).
• Common CS etiologies included acute on chronic heart failure (52%) and postcardiotomy syndrome (24%).
• 49% of patients died on support, while 27% achieved myocardial recovery and 24% transitioned to durable LVADs. Access-related complications included bleeding (13.5%) and infection (9%).

Conclusions:

• ECMELLA 2.0/2.1 represents a feasible and effective treatment for severe CS.
• The single-artery cannulation approach is linked to a comparatively low incidence of access-related complications.