247. CCC: Biventricular Failure and the Use of VA-ECMO with Dr. Ann Gage

The podcast explores the utilization of Veno-Arterial ECMO (VA-ECMO) in managing severe refractory cardiogenic shock, particularly in cases of biventricular failure. Dr. Ann Gage, an expert in interventional and critical care cardiology, details the pathophysiology, hemodynamic disturbances, and patient selection criteria for VA-ECMO. The discussion covers the components and configurations of the ECMO circuit, emphasizing the importance of understanding baseline hemodynamics and potential complications like limb ischemia and North-South syndrome. Dr. Gage highlights the significance of left ventricular unloading strategies, such as intra-aortic balloon pumps and Impella, to mitigate the increased afterload introduced by ECMO. The podcast further addresses the challenges of balancing work and family in a two-physician household, offering advice on prioritization, delegation, and supporting colleagues.