[Successful Use of Percutaneous Left Ventricular Assist Device( Impella) and Veno Artery Extracorporeal Membrane Oxygenation( VA-ECMO) for Ischemic Cardiogenic Shock;Report of a Case].

A 73-year-old male was referred to our hospital for acute congestive heart failure. His cardiac and respiratory conditions were worsening with cardiogenic shock requiring intubation. Coronary angiography revealed severe triple vessel disease, and echocardiography showed severe left ventricular dysfunction. Therefore, he underwent veno artery extracorporeal membrane oxygenation (VA-ECMO) followed by percutaneous left ventricular assist device (Impella). His cardiac condition improved and VA-ECMO and Impella were removed on the 2nd day and the 4th day after surgery, respectively. He underwent off-pump coronary artery bypass grafting (OPCAB) without any complication on the 36th day. Postoperative course was uneventful and he was discharged on postoperative day 30. Concomitant use of Impella and VA-ECMO (Ecpella) remarkably improved ischemic cardiogenic shock by unloading the left ventricle and increasing the cardiac output.