ECPR in acute aortic dissection – Really a no-go?

The use of extracorporeal membrane oxygenation (ECMO) [1] and its implementation into institutional protocols for extracorporeal cardiopulmonary resuscitation (ECPR) is rapidly increasing [1-3]. One of the commonly reported contraindications of veno-arterial ECMO is acute aortic dissection, however no studies on feasibility, safety and efficacy of ECPR in this condition exist. In this context we read with great interest the report of Kelly et al. in the Journal [4]. While we fully agree that transesophageal echocardiography (TEE) is still underutilized especially in emergency medicine and intensive care, the decision against veno-arterial ECMO upon identification of acute aortic dissection Type A (AADA) raised some concerns to us.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research