Malignancy-Induced Functional Tricuspid Obstruction Complicated by Cardiopulmonary Collapse Treated Using Combination VA-ECMO and AngioVac

• DOI: 10.1016/j.jaccas.2025.103692
• Publication Date: 2025-04-03T05:48:12Z
• Authors: Hafez Golzarian; Anna C. Kleman; Mallory Knous; Janelle Fields; Dylan Pitts; Andria L. Utendorf; Amanda Laird; Aakash Kumar; William C. Cole; Robert A. Baiocchi; Sandeep M. Patel

Right-sided intracardiac masses, often arising from metastatic malignant diseases infiltrating the central venous system, may cause profound hemodynamic instability and life-threatening obstructive shock. The authors present a case demonstrating extent of both diagnostic therapeutic utility percutaneous large-bore vacuum-assisted aspiration thrombectomy in patient presenting with tumor-induced tricuspid valve obstruction shock subsequent cardiac arrest. Our was successfully resuscitated venoarterial (VA) extracorporeal membrane oxygenation (ECMO) bridge to large obstructing tumor by using system. This demonstrates successful use conjunction VA ECMO manage mass Large-bore facilitated stabilization rapid tissue diagnosis, which crucial for guiding further management. Although aggressive intervention such cases initially seem unorthodox, particularly suspected disease, this highlights its potential benefits when combined multidisciplinary approach strong consideration family goals care.