Refractory Impella Suction Alarms in the Setting of Extracorporeal Membrane Oxygenation

Abstract Cardiogenic shock is an uncommon but serious complication of acute myocardial infarction. Temporary mechanical circulatory support devices are being used more often in this setting and physicians are required to be familiar with their complications. While VA ECMO increases after load, an impella device can be inserted to unload the left ventricle and decrease its oxygen consumption. Here, we present an uncommon cause of refractory Impella suction alarm which was related to the migration of the venous ECMO cannula into the left atrium.