V-AV: the Y stole the artery

Handover

Fem-fem VA for cardiogenic shock. The heart recovered enough to make Harlequin, so the team spliced a RIJ venous return (V-AV). Right-hand sat is now 93% — but MAP is 52 and falling. Total pump flow 4.6 L. Nobody put a Hoffman clamp on the Y. Bedside Doppler: Qven 3.5 L, Qart 1.1 L. One pump, two returns. The venous limb is low-resistance.