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Heart Failure pp 289-298 | Cite as

Veno-Arterial ECMO

  • P. LeprinceEmail author
  • G. Lebreton
Chapter
Part of the Cardiovascular Medicine book series (CVM)

Abstract

Veno-arterial (VA) ecmo is an efficient circulatory support system to stabilize cardiogenic shock patients and bridge them to recovery, long term MCS or cardiac transplantation. Patient outcome will highly depend of shock etiology, timing of implantation and potential for heart function recovery. Moreover, VA ecmo is associated with several potentially devastating complications which can definitely impair the outcome of the patients if not efficiently prevented or treated. This is why, even if ecmo concept is very simple, management of ecmo patient requires a multidisciplinary team made of intensivist, surgeon, cardiologist and perfusionist as well as fully trained nurse staff.

Ecmo is the most efficient and the most adaptable short term circulatory support system but not the only one. There are indeed other systems like microaxial pumps which can be more suitable for specific situation. Thus, VA ecmo should be seen as part of a series of hemodynamic support tools which can be used separately, in continuity or even associated.

Finally, because ecmo implantation and even more patient management requires highly specialized team, the concept of ecmo network, mobile unit, and reference center is becoming critical and should be encouraged.

Keywords

Ecmo Cardiogenic shock Circulatory support Cardiac transplantation Acute heart failure Cardiac arrest 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Sorbonne UniversityAPHP, Groupe hospitalier Pitié SalpétrièreParisFrance

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