{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T15:35:30Z","timestamp":1772292930196,"version":"3.50.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an essential device in the field of emergency and intensive-care medicine. However, long-term use of VA-ECMO has various severe complications, including thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 60-year-old man underwent his third aortic root replacement using a homograft because of infectious endocarditis. Although the operation was difficult because of severe adhesion caused by the two previous interventions, aortic root replacement using a homograft was performed. At the time of withdrawal from cardiopulmonary bypass, the maintenance of hemodynamics was difficult because of bleeding from the surgical site, leading to hypovolemic shock. Cardiac function subsequently deteriorated; therefore, VA-ECMO was established and the operation was finished. Three days later, thrombus was formed inside the homograft and completely occluded ascending aorta. Evacuation of hematoma was performed, however, cardiac function was not ameliorated. Eventually, the patient had brain infarction and died. To prevent thrombus formation in very severe low cardiac output cases under VA-ECMO management after surgery, to prevent the stagnation of the blood flow from VA-ECMO will be necessary because anticoagulant therapy will be difficult. Impella ventricular assist device which is recently used widely generates anterograde blood flow and effectively prevents stagnation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To prevent thrombus formation in cases of very severe low cardiac output, Impella\u00ae should be combinatorially introduced from the beginning of VA-ECMO establishment to prevent thrombosis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13019-020-01239-3","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T12:03:26Z","timestamp":1595505806000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A case report of thrombotic complete obstruction of the ascending aorta as a complication of Venoarterial extracorporeal membrane oxygenation support: steps to prevent thrombosis"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-0458","authenticated-orcid":false,"given":"Tasuku","family":"Nishihara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuko","family":"Kudamatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taisuke","family":"Hamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Nakata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waichi","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideyuki","family":"Nandate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Namiguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Nishimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Izutani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Yorozuya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"issue":"7","key":"1239_CR1","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1111\/j.1525-1594.1997.tb03739.x","volume":"21","author":"T Ihno","year":"1997","unstructured":"Ihno T, Nakagawa T, Furukawa H, Shimizu K, Egi K, Maemura T, et al. Various problems during long-term percutaneous cardiopulmonary support. Artif Organs. 1997;21(7):766\u201371.","journal-title":"Artif Organs"},{"issue":"4","key":"1239_CR2","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1051\/ject\/201648162","volume":"48","author":"B Williams","year":"2016","unstructured":"Williams B, Bernstein W. Review of Venoarterial extracorporeal membrane oxygenation and development of Intracardiac thrombosis in adult cardiothoracic patients. J Extra Corpor Technol. 2016;48(4):162\u20137.","journal-title":"J Extra Corpor Technol"},{"issue":"3","key":"1239_CR3","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1097\/01.CCM.0000053522.55711.E3","volume":"31","author":"B Schwarz","year":"2003","unstructured":"Schwarz B, Mair P, Margreiter J, Pomaroli A, Hoermann C, Bonatti J, et al. Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support. Crit Care Med. 2003;31(3):758\u201364.","journal-title":"Crit Care Med"},{"issue":"4","key":"1239_CR4","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/j.ejcts.2009.10.006","volume":"37","author":"J Hajj-Chahine","year":"2010","unstructured":"Hajj-Chahine J, Tomasi J, Lanquetot H, Corbi P. Ascending aortic thrombosis in a patient on extra-corporeal membrane oxygenation. Eur J Cardiothorac Surg. 2010;37(4):953.","journal-title":"Eur J Cardiothorac Surg"},{"issue":"4","key":"1239_CR5","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1510\/icvts.2010.240689","volume":"11","author":"E Leontiadis","year":"2010","unstructured":"Leontiadis E, Koertke H, Bairaktaris A, Koerfer R. Thrombosis of the ascending aorta during mechanical circulatory support in a patient with cardiogenic shock. Interact Cardiovasc Thorac Surg. 2010;11(4):510\u20131.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"10","key":"1239_CR6","doi-asserted-by":"publisher","first-page":"E342","DOI":"10.1111\/echo.12323","volume":"30","author":"V Ramjee","year":"2013","unstructured":"Ramjee V, Shreenivas S, Rame JE, Kirkpatrick JN, Jagasia D. Complete spontaneous left heart and aortic thromboses on extracorporeal membrane oxygenation support. Echocardiography. 2013;30(10):E342\u20133.","journal-title":"Echocardiography"},{"issue":"3","key":"1239_CR7","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1007\/s00134-013-3173-8","volume":"40","author":"N Madershahian","year":"2014","unstructured":"Madershahian N, Weber C, Scherner M, Langebartels G, Slottosch I, Wahlers T. Thrombosis of the aortic root and ascending aorta during extracorporeal membrane oxygenation. Intensive Care Med. 2014;40(3):432\u20133.","journal-title":"Intensive Care Med"},{"issue":"1","key":"1239_CR8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s40981-016-0067-0","volume":"2","author":"Y Takei","year":"2016","unstructured":"Takei Y, Ejima Y, Toyama H, Takei K, Ota T, Yamauchi M. A case of a giant cell myocarditis that developed massive left ventricular thrombus during percutaneous cardiopulmonary support. JA Clin Rep. 2016;2(1):41.","journal-title":"JA Clin Rep"},{"issue":"1","key":"1239_CR9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.21037\/acs.2018.11.07","volume":"8","author":"A Xie","year":"2019","unstructured":"Xie A, Forrest P, Loforte A. Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation. Ann Cardiothorac Surg. 2019;8(1):9\u201318.","journal-title":"Ann Cardiothorac Surg"},{"issue":"3","key":"1239_CR10","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/MAT.0b013e31820e121c","volume":"57","author":"D Kawashima","year":"2011","unstructured":"Kawashima D, Gojo S, Nishimura T, Itoda Y, Kitahori K, Motomura N, et al. Left ventricular mechanical support with Impella provides more ventricular unloading in heart failure than extracorporeal membrane oxygenation. ASAIO J. 2011;57(3):169\u201376.","journal-title":"ASAIO J"},{"issue":"3","key":"1239_CR11","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1002\/ejhf.668","volume":"19","author":"F Pappalardo","year":"2017","unstructured":"Pappalardo F, Schulte C, Pieri M, Schrage B, Contri R, Soeffker G, et al. Concomitant implantation of Impella((R)) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. Eur J Heart Fail. 2017;19(3):404\u201312.","journal-title":"Eur J Heart Fail"},{"issue":"12","key":"1239_CR12","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1111\/aor.12923","volume":"41","author":"HS Lim","year":"2017","unstructured":"Lim HS. The effect of Impella CP on cardiopulmonary physiology during Venoarterial extracorporeal membrane oxygenation support. Artif Organs. 2017;41(12):1109\u201312.","journal-title":"Artif Organs"},{"issue":"1","key":"1239_CR13","first-page":"11","volume":"12","author":"K Moazzami","year":"2017","unstructured":"Moazzami K, Dolmatova EV, Cocke TP, Elmann E, Vaidya P, Ng AF, et al. Left ventricular mechanical support with the Impella during extracorporeal membrane oxygenation. J Tehran Heart Cent. 2017;12(1):11\u20134.","journal-title":"J Tehran Heart Cent"},{"issue":"5","key":"1239_CR14","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/MAT.0b013e31829f0e52","volume":"59","author":"A Cheng","year":"2013","unstructured":"Cheng A, Swartz MF, Massey HT. Impella to unload the left ventricle during peripheral extracorporeal membrane oxygenation. ASAIO J. 2013;59(5):533\u20136.","journal-title":"ASAIO J"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-020-01239-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-020-01239-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-020-01239-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T18:30:42Z","timestamp":1696444242000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-020-01239-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,23]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1239"],"URL":"https:\/\/doi.org\/10.1186\/s13019-020-01239-3","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,23]]},"assertion":[{"value":"21 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors obtained informed consent from the patient\u2019s guardian (patient\u2019s wife) regarding the publication of this case report and the use of related data by written form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"185"}}