Left Ventricular Apex Chimney Technique for Central Extracorporeal Life Support

In cardiogenic shock with severely compromised left ventricle (LV) function, systemic perfusion and LV unloading are crucial to reduce pulmonary afterload and thrombus risk. Peripheral extracorporeal life support (ECLS) is commonly used, but central ECLS with LV venting is often required when the peripheral support is insufficient. We propose the "LV apex chimney graft technique," a novel and straightforward method for direct LV cannulation via median sternotomy or left anterior thoracotomy. This approach allows for secure cannula fixation and effective LV venting in the central ECLS, minimizing bleeding risk and offering a reproducible technique.