Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Andreka, J; Zirngast, B; Toth, GG.
Microaxial Flow Pump for Left Ventricular Unloading After Aortic Valve Surgery: Overcoming Vascular and Valvular Barriers.
JACC Case Rep. 2025; 30(24):104683
Doi: 10.1016/j.jaccas.2025.104683
(- Case Report)
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- Leading authors Med Uni Graz
- Andreka Judit
- Toth-Gayor Gabor
- Co-authors Med Uni Graz
- Zirngast Birgit
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- Abstract:
- BACKGROUND: In hemodynamically unstable patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO), left ventricular unloading may be essential but technically challenging, especially after aortic valve replacement. CASE SUMMARY: We report a case of a 64-year-old male patient with postcardiotomy cardiogenic shock after combined coronary and aortic valve surgery. VA-ECMO alone was insufficient, prompting the use of a microaxial flow pump via axillary access. Challenges included left ventricle wiring through the closed bioprosthetic aortic valve and navigating a severely stenotic subclavian artery. A combination of advanced imaging and vascular techniques enabled successful device placement. TAKE-HOME MESSAGES: A transesophageal ultrasound-guided mother-and-child technique with steerable catheter allows precise control for atraumatic valve crossing in case of functionally closed aortic leaflets. Intravascular lithotripsy is a potent tool to facilitate large-bore access for mechanical circulatory support in patients with calcified peripheral artery disease.