Acute cardiac care & resuscitation
Atrial Septostomy and Left Ventricular Venting During Peripheral VA-ECMO
- retrospective study
- consecutive adults
- academic center (2019-2024)
+2 more
- consecutive adults
- academic center (2019-2024)
Authors' conclusion
Among patients receiving peripheral VA-ECMO for CS, BAS achieves atrial-level decompression and may provide durable LV venting in select patients, although venting failure remains common. Observed arterial pulse-pressure trajectories differed according to eventual LV venting failure status.
Study context
- Population
- Adults with cardiogenic shock (CS) supported with peripheral VA-ECMO who underwent balloon atrial septostomy (BAS) for left ventricular (LV) unloading
- Participants
- 28 adults
- Exposure
- BAS for LV venting during peripheral VA-ECMO
- Outcome
- LV venting failure (composite of pulmonary edema, LV distension, spontaneous echocardiographic contrast, LV or aortic root thrombus, stroke due to extracorporeal membrane oxygenation (ECMO), or escalation to additional mechanical support)
Main finding
As reported in the abstract
LV venting failure
53.6%
Observational data: associations, not effects.
Further findings
Mean left atrial pressure after BAS
- Reduction in mean left atrial pressure
- 20.5-13.5 mm Hg
- P value
- P < 0.001
Pulse-pressure trajectories by eventual LV venting-failure status
- Trajectories differed by eventual LV venting-failure status
- interaction P = 0.018
- Model-estimated pulse pressure higher at 48 hours among patients without venting failure
- P = 0.010
- Model-estimated pulse pressure higher at 72 hours among patients without venting failure
- P = 0.031
Original publication
Atrial Septostomy and Left Ventricular Venting During Peripheral VA-ECMO. JACC Adv. Published 16 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it