{
    "abstract": "The authors present the case of a young man who presented with cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation and microaxial flow pump complicated by acute spinal cord infarction (SCI) leading to bilateral lower extremity paraplegia.\nThe key questions included the following: 1) What is the incidence and pathophysiology for SCI with mechanical circulatory support (MCS)?; 2) Which configurations of MCS carry a greater risk of SCI? How do we approach MCS escalation, recognizing that with each device we carry additive risk of complications?; 3) What data guide anticoagulation strategies for MCS?; and 4) What strategies can we implement to support patients who have suffered SCI\u00a0from MCS?\nOur patient was transitioned to a right ventricular assist device with Impella 5.5 as a bridge to therapy, and underwent cardiac transplantation 4\u00a0weeks after presentation with ongoing inpatient rehabilitation.\nContemporary MCS carries a small but significant risk of SCI which is often irreversible. More data are required to guide anticoagulation strategies for MCS and mitigate risk.",
    "authors": [
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA. Electronic address: Arushi.singh@nyulangone.org.",
            "firstname": "Arushi",
            "initials": "A",
            "lastname": "Singh"
        },
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Syed Zain",
            "initials": "SZ",
            "lastname": "Ali"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Kelly A",
            "initials": "KA",
            "lastname": "Drozdowicz"
        },
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Amit",
            "initials": "A",
            "lastname": "Alam"
        },
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Randal I",
            "initials": "RI",
            "lastname": "Goldberg"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Justin C",
            "initials": "JC",
            "lastname": "Chan"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Marzia",
            "initials": "M",
            "lastname": "Leacche"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Nader",
            "initials": "N",
            "lastname": "Moazami"
        },
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Alex",
            "initials": "A",
            "lastname": "Reyentovich"
        },
        {
            "affiliation": "Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.",
            "firstname": "Bernard S",
            "initials": "BS",
            "lastname": "Kadosh"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jaccas.2025.103378",
    "journal": "JACC. Case reports",
    "keywords": [
        "Impella",
        "VA-ECMO",
        "cardiac transplantation",
        "cardiogenic shock",
        "mechanical circulatory support",
        "spinal cord infarction"
    ],
    "methods": null,
    "publication_date": "2025-04-05",
    "pubmed_id": "40185612",
    "results": null,
    "title": "Spinal Cord Infarction as a Complication of VA-ECMO With Microaxial Flow Pump in Cardiogenic Shock.",
    "xml": "<Element 'PubmedArticle' at 0x788504d89350>"
}