Related Experiment Video
Updated: May 16, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Spinal Cord Infarction as a Complication of VA-ECMO With Microaxial Flow Pump in Cardiogenic Shock
Arushi Singh1, Syed Zain Ali1, Kelly A Drozdowicz2
1Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.
Clinical Condition:
The authors present the case of a young man who presented with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation and microaxial flow pump complicated by acute spinal cord infarction (SCI) leading to bilateral lower extremity paraplegia.
Key Questions:
The key questions included the following: 1) What is the incidence and pathophysiology for SCI with mechanical circulatory support (MCS)?; 2) Which configurations of MCS carry a greater risk of SCI? How do we approach MCS escalation, recognizing that with each device we carry additive risk of complications?; 3) What data guide anticoagulation strategies for MCS?; and 4) What strategies can we implement to support patients who have suffered SCI from MCS?
Outcome:
Our patient was transitioned to a right ventricular assist device with Impella 5.5 as a bridge to therapy, and underwent cardiac transplantation 4 weeks after presentation with ongoing inpatient rehabilitation.
Take-Home Messages:
Contemporary MCS carries a small but significant risk of SCI which is often irreversible. More data are required to guide anticoagulation strategies for MCS and mitigate risk.
More Related Videos
Related Concept Videos
Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Vascular Spasm
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...

