The circulatory assistance, mainly the extra-corporeal membrane oxygenation (ECMO) restores hemodynamics and serves to limit the myocardial work, in order to avoid left ventricular dilation, high end-diastolic pressures, increased wall stress, subendocardial ischemia and consequently worsening pulmonary congestion and edema. In patients with large myocardial damage, sometimes an additional unloading of the left ventricle is warranted. We report a case of percutaneous blade and balloon atrial septostomy (BAS) as an add-on to the circulatory assistance to unload the left heart in a cardiogenic shock related to H1N1 infection.
- balloon atrial septostomy
- left ventricular dilation