First use of the Cardiohelp system in the ECMO-LVAD concept

We describe a 51-year-old man with cardiogenic shock and severe multi-organ failure in whom the new percutanoues extracoporeal life support (ECLS) system Cardiohelp (Maquet CP, Hirrlingen, Germany) was used in 3 different settings. Initially, the system was employed as venoarterial extracorporeal membrane oxygenation (ECMO) to restore cardiopulmonary stability. After successful stabilization, a pulsatile extracorporeal left ventricular assist device (LVAD) was implanted during ECMO support with the heart beating to reduce the negative effects associated with conventional cardiopulmonary bypass (CPB) systems. After LVAD placement, the ECMO was switched to a temporary right ventricular support to avoid right venticular failure, which could be terminated after 5 days. In conclusion, a simple ECLS set-up and integrated systems like the new Cardiohelp system are highly versatile instruments to differenzially stabilize patients in various situations with cardiopulmonary compromise. The miniaturized extracorporeal circulation devices can give significant support from resuscitation until heart transplantation, and thereafter.