Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.
C, W., P, D.N., S, H., E, F., & F, S. (2026). Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.. The journal of extra-corporeal technology. https://doi.org/10.1051/ject/2026001
C W, P DN, S H, E F, F S. Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.. The journal of extra-corporeal technology. 2026; doi: 10.1051/ject/2026001
C W, P DN, S H, et al. Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.[J]. The journal of extra-corporeal technology. 2026. DOI: 10.1051/ject/2026001.
@article{c2026,
author = {Wirth C and De Normandie P and Hascoet S and Fadel E and Stephan F},
title = {Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension.},
journal = {The journal of extra-corporeal technology},
year = {2026},
doi = {10.1051/ject/2026001},
note = {PMID: 42319106},
}
TY - JOUR AU - Wirth C AU - De Normandie P AU - Hascoet S AU - Fadel E AU - Stephan F TI - Learning from a pitfall: Atrial septostomy in LV failure under VA-ECMO for pulmonary hypertension. T2 - The journal of extra-corporeal technology PY - 2026 DO - 10.1051/ject/2026001 AN - PMID:42319106 ER -
BACKGROUND: Atrial septostomy has been successfully used in patients with pulmonary hypertension and in those supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) complicated by pulmonary congestion. CASE DESCRIPTION: We report a patient on VA-ECMO for decompensated pulmonary hypertension who subsequently developed stress-induced cardiomyopathy and pulmonary congestion. An atrial septostomy was performed, which led to worsening respiratory status due to the creation of a right-to-left shunt, and hemodynamic deterioration resulting from increased left ventricular preload. CONCLUSION: The implications of atrial septostomy should be carefully considered prior to decompression, as there may be situations, especially if right-sided pressures are less than left-sided pressures, where patients may still benefit.