Impella LP 2.5 for left ventricular unloading during venoarterial extracorporeal membrane oxygenation support.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is commonly used as a means of support for acute cardiopulmonary failure. In the setting of severe left ventricular (LV) dysfunction, VA-ECMO may be complicated by LV distension, which can lead to pulmonary edema and compromise myocardial recovery. Traditional decompression methods carry significant risk. We report the use of the Impella LP 2.5 for LV decompression in a 70-year-old man with decompensated heart failure who was placed on VA-ECMO for cardiogenic shock with severe pulmonary edema and respiratory failure. Both devices were successfully weaned on day 5 of VA-ECMO support, after myocardial recovery.