VA ECMO for severe acute heart failure in adults

Venoarterial extracorporeal membrane oxygenation (VA ECMO) can be offered to adults with severe acute heart failure as a bridge to recovery or having a heart transplant or an implanted left ventricular assist device.

In VA ECMO, blood is taken from the venous system (usually from the femoral vein or directly from the right atrium) and pumped through an oxygenator, where oxygen and carbon dioxide are exchanged. It is then returned to the arterial system, usually through the femoral or axillary artery or ascending aorta. People are given a continuous infusion of an anticoagulant, usually heparin, to prevent blood clotting in the extracorporeal system. For people with poor kidney function, a haemofiltration unit may be added to the circuit.