{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T15:28:08Z","timestamp":1775834888366,"version":"3.50.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Post-myocardial infarct (MI) ventricular septal defect (VSD) is a rare and severe complication of an acute MI with high mortality rate. The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to surgical or percutaneous repair in cardiogenic shock secondary to post-MI-VSD has been published, but is limited to small case series primarily utilizing surgical ECMO, with the main drawback of potentially increasing afterload and left ventricle pressure, further worsening VSD shunting. Left-atrial VA-ECMO (LAVA-ECMO) can potentially absolve this concern given that it utilizes bi-atrial drainage through a trans-septal fenestrated cannula.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>Five patients were included in this series, all with VSD secondary to MI, and all managed with LAVA-ECMO as a bridge to repair. Average age was 62 \u00b1 4.2 years, body mass index of 29.4 \u00b1 4.5\u2005kg\/m2, and left ventricular ejection fraction of 46.6 \u00b1 13.8%. Haemodynamics monitoring pre- and post-LAVA-ECMO demonstrated improvement in right atrial, right ventricular, pulmonary, left atrial, and left ventricular pressures (Figure 1). Average time to repair was 7.4 \u00b1 3.9 days. All five patients survived to repair, with four undergoing surgical and one undergoing percutaneous closure. Four out of five patients were decannulated successfully.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case series reports the successful use of LAVA-ECMO as a bridge to MI-VSD repair in patients with cardiogenic shock. Left-atrial VA-ECMO serves as a convenient approach to managing patients with MI-VSD related cardiogenic shock as it is implanted percutaneously, and can be done at the time of shock diagnosis, during right heart catheterization by trained interventionists.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf095","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T11:08:11Z","timestamp":1740481691000},"source":"Crossref","is-referenced-by-count":1,"title":["Left atrial veno-arterial extracorporeal membrane oxygenation as a bridge to surgical or percutaneous closure of post-myocardial infarction ventriculoseptal defects: a case series"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9243-5196","authenticated-orcid":false,"given":"Raef","family":"Fadel","sequence":"first","affiliation":[{"name":"Cardiovascular Medicine, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Elderkin","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussayn","family":"Alrayes","sequence":"additional","affiliation":[{"name":"Structural Heart Disease, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"Giustino","sequence":"additional","affiliation":[{"name":"Structural Heart Disease, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberio","family":"Frisoli","sequence":"additional","affiliation":[{"name":"Structural Heart Disease, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mir Babar","family":"Basir","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Apostolou","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Structural Heart Disease, Henry Ford Hospital , 2799 W Grand Blvd, Detroit, MI 48202 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"2025031806314874300_ytaf095-B1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1161\/01.CIR.101.1.27","article-title":"Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction","volume":"101","author":"Crenshaw","year":"2000","journal-title":"Circulation"},{"key":"2025031806314874300_ytaf095-B2","volume-title":"Contemporary Management of Post-MI Ventricular Septal Rupture","author":"Goyal","year":"2018"},{"key":"2025031806314874300_ytaf095-B3","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/jocs.12561","article-title":"Mechanical circulatory support as a bridge to definitive surgical repair after post-myocardial infarct ventricular septal defect","volume":"30","author":"Hobbs","year":"2015","journal-title":"J Card Surg"},{"key":"2025031806314874300_ytaf095-B4","doi-asserted-by":"crossref","first-page":"e005981","DOI":"10.1161\/CIRCHEARTFAILURE.119.005981","article-title":"Haemodynamic effects of mechanical circulatory support devices in ventricular septal defect","volume":"12","author":"Pahuja","year":"2019","journal-title":"Circ Heart Fail"},{"key":"2025031806314874300_ytaf095-B5","doi-asserted-by":"crossref","first-page":"100117","DOI":"10.1016\/j.shj.2022.100117","article-title":"Left atrial-veno-arterial extracorporeal membrane oxygenation: step-by-step procedure and case example","volume":"6","author":"Lemor","year":"2022","journal-title":"Struct Heart"},{"key":"2025031806314874300_ytaf095-B6","first-page":"qcac076","article-title":"Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs. without left ventricular unloading by Impella: a systematic review and meta-analysis","volume":"9","author":"Cappannoli","year":"2023","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2025031806314874300_ytaf095-B7","doi-asserted-by":"crossref","first-page":"e025274","DOI":"10.1161\/JAHA.122.025274","article-title":"Intra-aortic balloon pump for left ventricular unloading in veno-arterial extracorporeal membrane oxygenation: the last remaining indication in cardiogenic shock","volume":"11","author":"Bansal","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2025031806314874300_ytaf095-B8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.21037\/atm.2020.03.152","article-title":"Complications associated with mechanical circulatory support","volume":"8","author":"Ali","year":"2020","journal-title":"Ann Transl Med"},{"key":"2025031806314874300_ytaf095-B9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.amjcard.2024.11.005","article-title":"Haemodynamic effects and clinical outcomes of left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) in cardiogenic shock","volume":"236","author":"Villablanca","year":"2024","journal-title":"Am J Cardiol"},{"key":"2025031806314874300_ytaf095-B10","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1016\/S0140-6736(24)01818-X","article-title":"Cardiogenic shock","volume":"404","author":"L\u00fcsebrink","year":"2024","journal-title":"Lancet"},{"key":"2025031806314874300_ytaf095-B11","doi-asserted-by":"crossref","first-page":"ytad393","DOI":"10.1093\/ehjcr\/ytad393","article-title":"Left atrial veno-arterial extracorporeal membrane oxygenation in post-myocardial infarction ventricular septal defect with cardiogenic shock: a case report","volume":"7","author":"Jim\u00e9nez-Rodr\u00edguez","year":"2023","journal-title":"Eur Heart J Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf095\/62165701\/ytaf095.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/3\/ytaf095\/62165701\/ytaf095.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/3\/ytaf095\/62165701\/ytaf095.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T06:32:06Z","timestamp":1742279526000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf095\/8042009"}},"subtitle":[],"editor":[{"given":"Josip Andelo","family":"Borovac","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Zouheir","family":"Bitar","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Felice","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ayse","family":"Djahit","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Elton","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf095","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,3]]},"published":{"date-parts":[[2025,2,25]]},"article-number":"ytaf095"}}