{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:10:52Z","timestamp":1778238652439,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extracorporeal Cardiopulmonary Resuscitation (ECPR) is a lifesaving intervention for in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA). However, severe aortic regurgitation (AR) has traditionally been considered an absolute contraindication for veno-arterial extracorporeal membrane oxygenation (V-A ECMO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 63-year-old man with aortic regurgitation experienced IHCA with 50\u00a0min of low-flow time. The patient received ECPR and emergent valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) through a rapid multidisciplinary approach. Despite transient focal neurological symptoms in the early post-resuscitation period, the patient steadily recovered and was discharged with a favourable Cerebral Performance Category (CPC) of 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case challenges the absolute contraindication of severe aortic regurgitation for veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and ECPR candidacy, demonstrating that a multidisciplinary approach with planned venting strategies and rapid definitive intervention can lead to satisfactory patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe aortic regurgitation may not absolutely preclude candidacy for peripheral V-A ECMO. A pre-emptive approach integrating detailed venting strategies with emergent transcatheter interventions expands the salvageable population with valvular heart disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251415340","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:30:36Z","timestamp":1778049036000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary approach to prolonged in-hospital cardiac arrest (IHCA) managed by ECPR and emergent valve-in-valve transcatheter aortic valve implantation"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9057-7879","authenticated-orcid":false,"given":"Fung Ming Brian","family":"Lau","sequence":"first","affiliation":[{"name":"Queen Mary Hospital"},{"name":"The University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sin Kwan Tammy","family":"Ma","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheung Chi Simon","family":"Lam","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze Hui","family":"Yeoh","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai Kit","family":"Chan","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Wai","family":"Ngai","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching Wai","family":"Sin","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"},{"name":"The University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline Yeung","family":"Ng","sequence":"additional","affiliation":[{"name":"Queen Mary Hospital"},{"name":"The University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001344"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2016.12.011"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659115591622"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.09.032"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.062371"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2014.05.006"},{"key":"e_1_3_6_8_2","first-page":"e25","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular\u00a0Heart Dishase: A Rdpart of rhe American College of cardiology\/American Heact Asshciation Joint Committee on clinical Practice Guipelines","volume":"77","author":"Writing Committee Members","year":"2021","unstructured":"Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC\/AHA guideline for the management of patients with valvular\u00a0Heart Dishase: A Rdpart of rhe American College of cardiology\/American Heact Asshciation Joint Committee on clinical Practice Guipelines. J Am Coll Cardiol 2021; 77: e25\u2013e197.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-23-00473"},{"key":"e_1_3_6_10_2","first-page":"e66964","article-title":"Emergency and Prophylactic Extracorporeal Membrane Oxygenation for Patients Undergoing Valve-in-Valve Transcatheter Aortic Valve Implantation With Small Surgical Bioprosthesis: A Report of Four Cases","volume":"16","author":"Watanabe E","year":"2024","unstructured":"Watanabe E, Kometani S, Tsutsumi J, et al. Emergency and Prophylactic Extracorporeal Membrane Oxygenation for Patients Undergoing Valve-in-Valve Transcatheter Aortic Valve Implantation With Small Surgical Bioprosthesis: A Report of Four Cases. Cureus 2024; 16: e66964.","journal-title":"Cureus"},{"key":"e_1_3_6_11_2","first-page":"894","article-title":"External Validation of the RESCUE-IHCA Score as a Predictor for In-Hospital Cardiac Arrest Patients Receiving Extracorporeal Cardiopulmonary Resuscitation","volume":"25","author":"Ho YJ","year":"2024","unstructured":"Ho YJ, Su PI, Chi CY, et al. External Validation of the RESCUE-IHCA Score as a Predictor for In-Hospital Cardiac Arrest Patients Receiving Extracorporeal Cardiopulmonary Resuscitation. West J Emerg Med 2024; 25: 894\u2013902.","journal-title":"West J Emerg Med"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06198-w"},{"key":"e_1_3_6_13_2","first-page":"279","article-title":"Long-term outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest: Analysis of EXCEL registry data","volume":"26","author":"Pound G","year":"2024","unstructured":"Pound G, Jones D, Eastwood GM, et al. Long-term outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest: Analysis of EXCEL registry data. Crit Care Resusc 2024; 26: 279\u2013285.","journal-title":"Crit Care Resusc"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251415340","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591251415340","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251415340","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:46:24Z","timestamp":1778237184000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591251415340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":12,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/02676591251415340"],"URL":"https:\/\/doi.org\/10.1177\/02676591251415340","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}