Bilateral antegrade perfusion of the superficial femoral artery to prevent limb ischaemia during combined use of Impella CP left ventricular assist device and extracorporeal life support.

The combined use of extracorporeal cardiac life support and the Impella left ventricular assist device is feasible in severe cardiogenic shock. Ischaemic complications due to the arterial cannulation may occur. The following cases show how the use of a perfusion adapter for bilateral antegrade leg perfusion prevents malperfusion of the lower extremities.