Comparative Efficacy and Safety of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Versus Impella for Cardiogenic Shock: A Systematic Review and Meta-Analysis

February 24, 2026 No Comments

This systematic review and meta-analysis of 10 observational studies (5,364 patients) compared Impella and VA-ECMO for cardiogenic shock. No significant difference in short-term mortality was found (RR 0.92). However, Impella was associated with lower risks of stroke, major bleeding, and limb ischemia. Evidence certainty was very low due to confounding bias. Device selection should be individualized pending randomized trials.

Clinical and Preclinical Evidence on a Novel Percutaneous Pulsatile Ventricular Assist Device (PulseCath): Protocol for a Scoping Review

May 13, 2025 No Comments

This protocol outlines a scoping review to explore the clinical and preclinical applications of PulseCath, a novel percutaneous pulsatile ventricular assist device. Designed to bridge the gap between intra-aortic balloon pumps and Impella systems, PulseCath offers intermediate support for patients with hemodynamic instability. The review will systematically evaluate its hemodynamic effects, pathophysiological basis, and safety profile.

Multicentre Comparison of Various Microaxial Pump Devices as a Bridge to Durable Assist Device Implantation

April 4, 2025 No Comments

This multicentre retrospective study evaluated the effectiveness of different microaxial flow pump (mAFP) devices—mainly Impella CP (3.5 L/min) and Impella 5+ (>5 L/min)—used to stabilize patients with severe heart failure before durable LVAD implantation. High-flow mAFPs were associated with improved hemodynamic support, reduced complications (e.g., renal/liver failure, RVAD use), and better mobilization, although 30-day mortality did not differ significantly between groups.

Perioperative Mechanical Circulatory Support: Transitioning from Sequential to Parallel Recovery

February 7, 2025 No Comments

This editorial explores the evolution of mechanical circulatory support (MCS) in perioperative cardiac care. It discusses advancements in venoarterial extracorporeal membrane oxygenation (VA-ECMO) and micro-axial flow pumps, highlighting the shift from sequential to parallel recovery. The article emphasizes early MCS intervention, left ventricular unloading, and minimizing adverse events. Insights from the DanGer Shock trial suggest improved survival with early MCS use, but further research is needed for perioperative applications.

Clinical Outcomes of Cardiac Transplantation in Heart Failure Patients with Previous Mechanical Cardiocirculatory Support

January 18, 2025 No Comments

This study evaluates the long-term outcomes of heart failure patients undergoing cardiac transplantation with prior left ventricular assist device (LVAD) use as a bridge-to-transplant (BTT) compared to direct-to-transplant (DTT). The findings indicate similar survival rates at 1 and 7 years post-transplant in both groups. Although LVADs increase surgical complexity and incidence of cerebrovascular events, they do not negatively affect overall outcomes, supporting their viability in advanced heart failure care.

The Role of Impella in the Pre-Procedural Management of Post-Infarct Ventricular Septal Defect: A Systematic Review

December 17, 2024 No Comments

This systematic review explores the use of the Impella device in patients with post-infarct ventricular septal defect (VSD) prior to definitive treatment. Analyzing 68 patients across 20 studies, the Impella improved hemodynamic stability, reduced left ventricular strain, and delayed urgent intervention. Patients with surgically-placed Impella devices showed lower mortality and fewer complications compared to percutaneous alternatives. While effective, complications like bleeding and hemolysis must be carefully managed.

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

December 3, 2024 No Comments

A conceptual representation of the “Five Pillars” framework for aRHF therapy. The image shows five pillars, each labeled with key aspects: Etiological Treatment, Hemodynamic Support, Ventilation, Fluid Optimization, and Mechanical Support. A heart is balanced on top of these pillars, symbolizing stability. The design is clean and professional, with subtle arrows indicating the interconnectedness of the pillars.

Efficacy and Safety of Impella in Cardiogenic Shock Following Acute Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials

December 3, 2024 No Comments

This meta-analysis reviewed four randomized controlled trials (442 patients) to evaluate the use of Impella in managing cardiogenic shock (CS) following acute myocardial infarction (AMI). Impella reduced 6-month all-cause mortality (OR: 0.64, 95% CI: 0.43-0.95, P = .03) but showed no significant impact on 30-day mortality. However, Impella was linked to increased risks of major bleeding (OR: 3.61), limb ischemia (OR: 4.91), and sepsis (OR: 2.75). Future research is needed to balance survival benefits against these complications.

Effects of Cardiac Rehabilitation in Patients with Ventricular Assist Devices: A Scoping Review

September 21, 2024 No Comments

This review explores the impact of cardiac rehabilitation programs on patients with ventricular assist devices (VADs). It highlights the benefits of exercise-based rehabilitation in improving cardiorespiratory fitness and exercise tolerance. The most common approach is high-intensity interval training (HIIT), followed by moderate-intensity exercise. The findings suggest that cardiac rehabilitation is safe and effective for VAD patients, leading to improved health outcomes.

Hospital Readmissions in Patients Supported with Durable Centrifugal-Flow Left Ventricular Assist Devices

May 28, 2024 No Comments

The study examines hospital readmissions in patients with centrifugal-flow left ventricular assist devices (CF-LVADs), highlighting the commonality and impact on patient outcomes. Analyzing data from 204 patients, 67.7% experienced heart failure (HF)/LVAD-related readmissions, mainly due to major bleeding, infection, HF exacerbation, and neurological dysfunction. Using machine learning models, several pre-, intra-, and post-operative factors were identified as predictors of readmission risk, which can guide strategies to improve patient management and outcomes.