ECPELLA bridge to heart transplantation for a large ischemic ventricular septal defect and refractory ventricular arrhythmias

Post-myocardial infarction (MI) ventricular septal defects (VSDs) are rare but life-threatening. Temporary mechanical support options range from intra-aortic balloon pumps (IABPs) to venoarterial extracorporeal membrane oxygenation (VA-ECMO). There are few anecdotes of the Impella as a bridge to repair. We present a case of post-MI VSD and cardiogenic shock requiring combined Impella 5.5 and VA-ECMO (ECPELLA) as a bridge to transplant.