Floating Clots in the Descending Aorta A Rare Complication of Femoral Venoarterial Extracorporeal Membrane Oxygenation Combined With Microaxial Pump for Cardiogenic Shock

摘要

Left ventricular (LV) distension during femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) support is an untoward complication, leading to pulmonary edema, insufficient myocardial recovery, and LV thrombosis. 1 Impella (Abiomed, Danvers, MA) has been reported to effectively decompress such a distended LV with minimal invasion. (2) However, we encountered a rare case who developed a huge thrombus in the descending aorta resulting from the stagnation of blood flow because of interaction between antegrade (Impella) and retrograde (VA-ECMO) flows despite adequate anticoagulation.