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Objectives: Patients with profound cardiovascular compromise have poor prognosis despite inotropic and intra-aortic balloon pump (IABP) support. Peripheral venoarterial extracorporeal membrane oxygenation (V-A ECMO) offers these patients temporary support as a bridge to various options including the ‘bridge to recovery'. Methods: We studied the outcomes of 135 patients who underwent peripheral V-A ECMO and concomitant IABP implantation in our hospital from 2007 to 2012 for various clinical indications. The ECMO circuit consisted of a centrifugal pump and an oxygenator. Results: V-A ECMO was implanted in the cardiac catheterization laboratory in 51 patients (37.8%), at the bedside in 5 (3.7%) and in the operating room in 79 (58.5%). Mean duration of support was 8.5 ± 7.1 days. Median length of stay was 28 days (interquartile range 14-62). Complications included bleeding at the access site in 14.1%, stroke in 11.1% and vascular complications requiring intervention in 16.3%. Overall inhospital survival was 57.8% with outcomes including heart transplantation (3%), implantable left ventricular assist device (8.1% as bridge to transplantation and 6.7% as destination therapy), surgery (7.4%) and myocardial recovery (40.7%). Prior IABP use and axillary cannulation were independent predictors of reduced inhospital mortality, stroke or vascular injury. Conclusions: Peripheral V-A ECMO with IABP is an effective therapy for patients with severely compromised cardiovascular function. It offers reasonable survival and a spectrum of definitive options from ‘bridge to recovery' to heart transplantation for the management of this critically ill population.

Impact of transcatheter heart valve(THV) selection on prosthesis-patient mismatch(PPM) remains unknown. We aimed to compare incidence of moderate and severe PPM between Sapien3(S3) and EvolutR/Pro(ERP) in a theoretical model. From 10/2015 to 9/2018, standardized effective orifice area(EOA) of 1401

Transcatheter aortic valve replacement (TAVR) is expanding to younger patients, but the feasibility of TAVR in failing transcatheter aortic valves (TAV) remains unknown. We determine the feasibility of TAV-in-TAV after SAPIEN 3 (S3) TAVR. From October 2015 to April 2019 at 2 centers, 610 S3 TAVRs

Left atrial pressure (LAP) and V-wave reduction are markers of successful transcatheter mitral repair but no simple method of continuous monitoring exists. We report our multicenter experience on continuous LAP monitoring during MitraClip repair. From 11/2016 to 8/2017, 74 prohibitive risk patients

Severe aortic stenosis (AS) can adversely affect right ventricular function (RVF). RVF is an important determinant of transcatheter aortic valve replacement (TAVR) outcomes. Immediate changes in echocardiographic parameters of RVF have not been previously reported. We report changes in

Patients with aortic stenosis undergoing TAVR often have mitral disease. Transcatheter mitral valve replacement (TMVR) is a potential option in these patients, but TAVR may affect mitral annular geometry impacting their candidacy for TMVR. We evaluated mitral annular characteristics before and after

Patients with aortic stenosis undergoing TAVR often have severe mitral regurgitation. Some of them are not anatomical candidates for Mitraclip. Transcatheter mitral valve replacement (TMVR) is a promising alternative, but risk left ventricular outflow tract obstruction (LVOTO). Aortomitral annular

Annular sizing predicts paravalvular leak (PVL) and new persistent left bundle branch block (pLBBB), but little is known on Left Ventricular Outflow Tract (LVOT) anatomy on TAVR outcomes. We propse an LVOT seal zone to quantify LVOT-Annular mismatch and derive a “non-tubular index (NTI)”, to