Why the study?
Aortic stenosis is a serious valvular disease that increases the risk of cardiac arrest or cardiogenic shock during noncardiac surgery.
V-A ECMO via right axillary artery cannulation can be a viable strategy for extracorporeal cardiac support during EVAR in patients with severe comorbidities who develop cardiogenic shock.
May support emergency axillary cannulation for VA-ECMO during EVAR with aortic stenosis and shock; leaves open need for systematic evaluation.
Aortic stenosis is a serious valvular disease that increases the risk of cardiac arrest and/or cardiogenic shock during noncardiac surgery. A 93-year-old woman with an abdominal aortic aneurysm impending rupture and aortic stenosis underwent endovascular abdominal aortic aneurysm repair. During surgery, the patient presented with ventricular tachycardia. Due to on-going cardiogenic shock, we did a direct cannulation into the right axillary artery for the immediate establishment of venoarterial extracorporeal membrane oxygenation. The endovascular treatment of the abdominal aortic aneurysm was completed according to the standard procedure. The patient recovered without any complications, including heart failure or neurological dysfunction.
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Kawatani et al. (2020) studied this question.
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