{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T18:58:24Z","timestamp":1781895504114,"version":"3.54.5"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,9,6]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Left ventricular overload is frequent under veno\u2010arterial extracorporeal membrane oxygenation, which is associated with a worsening of the prognosis of these patients. Several left heart decompression (LHD) techniques exist. However, there is no consensus on their timing and type. We aimed to describe characteristics and outcomes of patients undergoing LHD and to compare percutaneous atrioseptostomy (PA) to other LHD techniques.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Retrospective analysis was conducted of consecutive and prospectively collected patients supported by veno\u2010arterial extracorporeal membrane oxygenation for refractory cardiac arrest or cardiogenic shock between January 2015 and April 2018, with a 90\u2010day follow\u2010up in our tertiary center. Patients were divided according to the presence of LHD, and then according to its type (PA versus others). Thirty\u2010nine percent (n=63) of our patients (n=163) required an LHD. Patients with LHD had lower left ventricular ejection fraction, more ischemic cardiomyopathy, and no drug intoxication\u2010associated cardiogenic shock. PA was frequently used for LHD (41% of first\u2010line and 57% of second\u2010line LHD). PA appears safe and fast to realize (6.3 [interquartile range, 5.8\u201310] minutes) under fluoroscopic and echocardiographic guidance, with no acute complications. PA was associated with fewer neurological complications (12% versus 38%,\n              <jats:italic>P<\/jats:italic>\n              =0.02), no need to insert a second LHD (0% versus 19%,\n              <jats:italic>P<\/jats:italic>\n              =0.04), and higher 90\u2010day survival compared with other techniques (42% versus 19%, log\u2010rank test\n              <jats:italic>P<\/jats:italic>\n              =0.02), despite more sepsis (96% versus 73%,\n              <jats:italic>P<\/jats:italic>\n              =0.02) and blood transfusions (13.5% versus 7%,\n              <jats:italic>P<\/jats:italic>\n              =0.01). Multivariate analysis confirms the association between PA and 90\u2010day survival (hazard ratio, 2.53 [1.18\u20135.45],\n              <jats:italic>P<\/jats:italic>\n              =0.019).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LHD was frequently used for patients supported with veno\u2010arterial extracorporeal membrane oxygenation, especially in cases of ischemic cardiomyopathy and low left ventricular ejection fraction. PA seems to be a safe and efficient LHD technique associated with greater mid\u2010term survival justifying the pursuit of research on this topic.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024642","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:03:27Z","timestamp":1661331807000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Use of Percutaneous Atrioseptotosmy for Left Heart Decompression During Veno\u2010Arterial Extracorporeal Membrane Oxygenation Support: An Observational Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9180-9128","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Delmas","sequence":"first","affiliation":[{"name":"Intensive Cardiac Care Unit Cardiology Department Rangueil University Toulouse France"},{"name":"Cardiology Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0350-6715","authenticated-orcid":false,"given":"Luigi","family":"Vallee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Bouisset","sequence":"additional","affiliation":[{"name":"Cardiology Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Porterie","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Biendel","sequence":"additional","affiliation":[{"name":"Intensive Cardiac Care Unit Cardiology Department Rangueil University Toulouse France"},{"name":"Cardiology Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-6582","authenticated-orcid":false,"given":"Olivier","family":"Lairez","sequence":"additional","affiliation":[{"name":"Cardiology Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Crognier","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Marcheix","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4110-7862","authenticated-orcid":false,"given":"Jean\u2010Marie","family":"Conil","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4800-1841","authenticated-orcid":false,"given":"Philippe","family":"Maury","sequence":"additional","affiliation":[{"name":"Cardiology Department Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-4939","authenticated-orcid":false,"given":"Vincent","family":"Minville","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care Medicine, and Perioperative Medicine Rangueil University Hospital Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1922"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000475"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036691"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659112443722"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.853"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.850"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa547"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.061"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872616675485"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.085"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.09.35"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006486"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-11-1015"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14560"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.924009"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25824"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22463"}],"container-title":["Journal 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