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Extra corporeal membrane oxygenation, specifically the veno-arterial type (VA-ECMO) is an effective cardiac support device but has potential negative effects, such as poor myocardial rest, increased after load with subsequent pulmonary edema or decreased flow to the left side of the heart resulting in intra-cardiac thrombus formation. Hence, adequate left ventricular drainage and adequate anticoagulation are essential. We are presenting a patient who required central VA-ECMO, but developed a left atrial (LA) thrombus, which adversely affected his outcome. In VA-ECMO, thrombus formation in the left side of the heart is a potential harmful complication. Early recognition is an important step to arrange appropriate interventions, either early anticoagulation or the potential need for a LV vent to prevent stasis.

LEFT ATRIUM THROMBUS ASSOCIATED WITH VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION (VA-ECMO)