- Author: In-Seok Jeong, Min Chul Kim, Yongwhan Lim, Youngkeun Ahn
- Date: 2024/06/18
- Journal: Circulation;149(25);e1417-e1417
- PMID: 38885301
- PMCID:
- DOI: 10.1161/CIRCULATIONAHA.124.069374
In Response
We appreciate Dr Jha’s interest in the EARLY-UNLOAD trial (Early Left Atrial Septostomy Versus Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation).1 In this study, we discussed the early routine left ventricular (LV) unloading compared with a conventional approach that allows rescue transseptal left atrial (LA) cannulation. Dr Jha has raised several important concerns regarding LV unloading, including the criteria for initiating LV unloading, the significance of pulse pressure as an indicator, the timing and rationale for rescue left atrial cannulation, and the implications of findings related to mitral regurgitation and venoarterial extracorporeal membrane oxygenation flow. We appreciate Dr Jha’s comments and are mainly responding to the rescue LA unloading in this letter.