Autopsy and clinical discrepancies in patients undergoing extracorporeal membrane oxygenation: a case series—a step towards understanding “Why”?

Veno-arterial extracorporeal membranous oxygenation (VA-ECMO) is a form of temporary mechanical circulatory support that is used as a salvage technique in cardiac arrest and cardiogenic shock. The setting up of an ECMO is often a difficult decision that is taken in an emergency environment, in hemodynamically unstable patients. Despite all advances that veno-arterial ECMO has witnessed over the past 50 years (1), its related mortality is still very high. Referring to the Extracorporeal Life Support Organization (ELSO) registry, VA-ECMO cardiac patients have overall survival to discharge of only 43% (2).