Transitioning from VA-ECMO to a central temporary LVAD via LV apical cannulation can be an effective strategy for managing bioprosthetic mitral valve thrombosis in postcardiotomy shock.
Venoarterial ECMO (VA-ECMO) is an important circulatory support modality for postcardiotomy shock at many institutions.1 Chiang and colleagues2 describe a 40-year-old woman who developed thrombosis on a recently implanted mitral valve bioprosthesis while she was supported with VA-ECMO. The authors successfully removed the thrombus surgically by changing the VA-ECMO support for a central temporary left ventricular assist device (LVAD) via LV apical cannulation. This elegant strategy allowed patient recovery with subsequent discharge from the hospital.
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Noly et al. (2020) studied this question.
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