Use of Extracorporeal Membrane Oxygenation and Impella as Bridge to Surgery Through Imaging for Cardiogenic Shock

ABSTRACT: Graphical abstract Three-dimensional TEE, zoomed volume acquisition, oriented to the surgeon's view of the mitral valve. (A) The left atrial erspective demonstrates a flail A3 segment with a ruptured posteromedial papillary muscle (arrow). (B) Three-dimensional color Doppler demonstrates severe MR. (C, D) Three-dimensional transillumination; left atrial (left) and LV (right) perspective demonstrated. This technique was used to highlight the blood pool–tissue interface. The degree of transparency was adjusted to maximize the border definition between the ruptured posteromedial papillary muscle and blood pool and more clearly demonstrate the ruptured posteromedial papillary muscle (dashed arrow). Highlights Echocardiography during VA-ECMO may identify the need for early LV unloading. Features to monitor include reduced aortic valve opening and aortic root stasis. Findings may guide LV unloading strategies and more effective hemodynamic support. This approach would be useful in MCS for cardiogenic shock due to acute severe MR.

SUBMITTER: Anastasius M 

PROVIDER: S-EPMC9271425 | biostudies-literature |

REPOSITORIES: biostudies-literature