Crisis Control: VA-ECMO - An Ischemic Leg!

CathMasters Drs. Nazli Okumus and Daniel Ambinder, along with expert faculty Drs. Ann Gage and Marwan Jumean, tackle the management of limb ischemia — one of the most feared complications of peripheral VA-ECMO (veno-arterial extracorporeal membrane oxygenation) and large-bore mechanical circulatory support (MCS). Through the case of a 50-year-old woman with ischemic cardiomyopathy on VA-ECMO and Impella CP who develops right leg ischemia, the team walks through bedside assessment of the ischemic limb, equipment and technique for placing a distal perfusion catheter (DPC) on an existing ECMO circuit, strategies to mitigate limb ischemia with Impella, assessment of vascular patency during large-bore access removal, and the recognition and management of compartment syndrome.

Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes.