Trans-aortic left ventricular unloading in VA-ECMO: the trans-subclavian route.

Left ventricular unloading (LVU) during extracorporeal life support aims to minimize potential side effects of increased left ventricular afterload. A transaortic catheter vent implanted through a subclavian approach was used in two patients. Case 1 was a 48-year-old male with a recent history of STEMI, who developed refractory cardiogenic shock due to severe biventricular dysfunction. In case 2, a 56-year-old male was admitted for severe flu. The unloading procedure was successful in both patients, with bridge to heart transplantation in the first case and bridge to recovery in the other.