Extracorporeal membrane oxygenation for right ventricular support in left ventricular assist device recipients

We present the case of a 65-year-old male, suffering from decompensated non-ischemic end-stage heart failure. He underwent mechanical aortic valve replacement and mitral valve annuloplasty 20 years ago and PCI of the LAD 5 years ago. Recent transthoracic echocardiography (TTE) showed a highly reduced left ventricular ejection fraction of 20%, a moderately reduced right ventricular function with moderate tricuspid valve regurgitation and an estimated systolic pulmonary pressure of 55 mmHg, as well as a moderate mitral valve regurgitation after annuloplasty. The aortic valve prosthesis showed a good long-term result with no signs for paravalvular leakage and a mean gradient of 4 mmHg