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Circ Heart Fail. 2018 Sep;11(9):e004905. doi: 10.1161/CIRCHEARTFAILURE.118.004905.

Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest.

Author information

Sarver Heart Center, University of Arizona, Tucson (P.R.).
Division of Cardiothoracic Surgery, Department of Surgery, University of Arizona, Tucson (Z.K.).
Artificial Heart and Perfusion Programs, Banner University Medical Center, Tucson, AZ (R.S.).
Cardiovascular Research Foundation, Columbia University Medical Center, New York, NY (D.B.).
Advanced Heart Failure and Mechanical Circulatory Support Program, University of Massachusetts Memorial Medical Center, Worcester (R.D.K.).


Venoarterial extracorporeal membrane oxygenation (VA-ECMO)-also referred to as extracorporeal life support-is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange. The initiation of VA-ECMO has emerged as a salvage intervention in patients with cardiogenic shock, even cardiac arrest refractory to standard therapies. Analogous to veno-venous ECMO for acute respiratory failure, VA-ECMO provides circulatory support and allows time for other treatments to promote recovery or may be a bridge to a more durable mechanical solution in the setting of acute or acute on chronic cardiopulmonary failure. In this review, we provide a brief overview of VA-ECMO, the attendant physiological considerations of peripheral VA-ECMO, and its complications, namely that of left ventricular distention, bleeding, heightened systemic inflammatory response syndrome, thrombosis and thromboembolism, and extremity ischemia or necrosis.


extracorporeal membrane oxygenation; heart arrest; hemorrhage; shock, cardiogenic; thrombosis

[Indexed for MEDLINE]

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