Journal of cardiology cases
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The Impella™ (Abiomed, Danvers, MA, USA) is a percutaneous left ventricular assist device and is concurrently used with veno-arterial extracorporeal membrane oxygenation (VA ECMO). However, concomitantly using these two devices makes identifying the mixed zone of two opposite blood flows difficult. We report the case of an 80-year-old man with ST-elevation myocardial infarction and cardiopulmonary arrest. ⋯ However, using these two devices may increase unexpected perfusion of unoxygenated blood in the coronary and cerebral arts. Veno-venous and arterial ECMO with the Impella can reduce the risk of hypoxia because of returned oxygenated blood to the inferior vena cava. This method might be useful for maintaining and weaning from simultaneous use of VA ECMO and the Impella.>.