Serial use of an interventional lung assist device and a ventricular assist device.

A low-resistance membrane oxygenator [interventional lung assist (iLA), Novalung, Hirrlingen, Germany] has been placed in series with a pulsatile extracorporeal left ventricular assist device (LVAD, Berlin Heart EXCOR, Berlin, Germany) in 1 circuit in a patient with postcardiotomy cardiopulmonary failure subsequent to 5 days of extracorporeal life support (ECLS or ECMO). This concept offers an intermediate step between ECLS and mechanical ventilation in this particular patient population. Pulmonary function stabilized under the combined lung and ventricular support. As a result, mechanical ventilation became sufficient after 48 hours, and the iLA was then removed easily out of the circuit. In conclusion, this case demonstrates the feasibility of integrating a low-resistance membrane oxygenator for additional lung support in extracorporeal LVAD patients.