Elsevier

The Annals of Thoracic Surgery

Volume 92, Issue 6, December 2011, Pages 2257-2259
The Annals of Thoracic Surgery

Case report
Left Ventricular Decompression During Peripheral Extracorporeal Membrane Oxygenation Support With the Use of the Novel iVAC Pulsatile Paracorporeal Assist Device

https://doi.org/10.1016/j.athoracsur.2011.05.063Get rights and content

Extracorporeal membrane oxygenation (ECMO) has become a widely accepted short-term mechanical circulatory support device in patients with refractory cardiogenic shock. A major drawback of the peripheral venoarterial extracorporeal membrane oxygenation is that in patients with profoundly reduced left ventricular contractility associated with high left-heart filling pressure, there is always concern for venting the failing ventricle. We describe a minimally invasive technique for decompressing the left ventricle in this setting using a novel pulsatile paracorporeal assist device, the iVAC 3L (PulseCath, Groningen, The Netherlands). It is implanted through the right axillary artery and provides hemodynamic support while directly off-loading the left ventricle.

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The iVAC is a minimally invasive circulatory assist device that effectively generates up to 3 L/minute of cardiac output. It is implanted through the right axillary artery and it directly unloads the LV by active blood aspiration during systole while it creates pulsatile flow into the ascending aorta in diastole. The device is pneumatic and it can be used with any standard IABP driver unit; thus, no dedicated hardware or other equipment is necessary. Considering that the membrane chamber can

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