title: Impella and extracorporeal membrane oxygenation: a demanding combination.
abstract: We report the case of a 34-year-old woman admitted in our institution for cardiogenic shock related to acute myocarditis. Initial hemodynamic instability required mechanical ventilation and peripheral venoarterial extracorporeal membrane oxygenation (ECMO). Secondary acute pulmonary edema after ECMO implantation required emergency left ventricular decompression with a percutaneous Impella Recover LP 5.0. After a short period of improvement, an unexpected technical problem led to the Impella Recover LP 5.0 arrest. The clinical situation quickly worsened, and the patient finally died. This case highlights the usefulness of Impella pump to unload left cardiac chambers but also its technical challenge when used in a patient on ECMO.
authors.affiliation: Department of Cardiothoracic Surgery, Pitié Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris, Université Paris VI Pierre et Marie Curie, France. sylvainbeurtheret@gmail.com
authors.forename: Sylvain
authors.initials: S
authors.lastname: Beurtheret
authors.forename: Pierre
authors.initials: P
authors.lastname: Mordant
authors.forename: Alain
authors.initials: A
authors.lastname: Pavie
authors.forename: Pascal
authors.initials: P
authors.lastname: Leprince
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D012770:Shock, Cardiogenic / Q000628:therapy*