International Perfusion Association


Category: VAD

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

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.


Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score

This study evaluates the mortality risk associated with infections in patients with left ventricular assist devices (LVAD). It highlights the development of a clinical risk prediction score based on factors like diabetes, type of Staphylococcus aureus infection, and treatment approaches including surgical debridement and flap reconstruction. Results indicate varying survival rates based on risk scores, suggesting that tailored surgical interventions may improve outcomes for patients with LVAD infections.

Cardiogenic Shock

Identifying and Mitigating Risk of Post-Cardiotomy Cardiogenic Shock in Patients with Ischemic and Non-Ischemic Cardiomyopathy

This study aimed to identify preoperative predictors of post-cardiotomy cardiogenic shock in patients with ischemic and non-ischemic cardiomyopathy, focusing on 238 patients undergoing cardiac surgery. It found that pulmonary artery pulsatility index and pulmonary capillary wedge pressure were key predictors, with the predictors varying between ischemic and non-ischemic conditions. The study highlights the importance of preoperative right heart catheterization in identifying patients at higher risk of cardiogenic shock. Ejection fraction improvements were noted at 12 months post-surgery.


Left-Ventricular Unloading With Impella During Refractory Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluates the efficacy of left-ventricular (LV) unloading with Impella, compared to standard venoarterial extracorporeal membrane oxygenation (VA-ECMO), during extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest. Analyzing data from 1014 patients across 32 hospitals, the study finds that ECMELLA (combined Impella and VA-ECMO) is associated with improved survival and neurological outcomes, especially in patients with acute myocardial infarction, compared to VA-ECMO alone. Despite a higher rate of complications, ECMELLA shows promise in enhancing patient recovery, underscoring the need for standardized guidelines for its use in ECPR.

Mechanical Support

Mechanical Circulatory Support – Primer for Consultant Specialists

This article serves as a primer on mechanical life support therapies, focusing on nonrenal extracorporeal life support for cardiac and pulmonary functions. It targets nephrologist consultants involved in treating critically ill patients, often facing acute renal injury from cardiopulmonary shock and mechanical circulatory support. The review underscores the importance of these life-sustaining tools in managing organ failure, either as a bridge to recovery or as a gateway to more permanent mechanical support solutions.


Evolution of Mechanical Circulatory Support for Advanced Heart Failure

This comprehensive review explores the significant advancements in Left Ventricular Assist Device (LVAD) therapy, particularly the evolution from early pulsatile flow systems to cutting-edge continuous-flow devices like the HeartMate 3 (HM3) LVAD. The review emphasizes improved survival rates, reduced complications, and enhanced quality of life for patients with advanced heart failure, discussing the dual role of LVADs as a bridge-to-transplantation and destination therapy, as well as emerging technologies and therapies for more effective, patient-centered treatment modalities.

Impella Device

Randomized Trials of Percutaneous Microaxial Flow Pump Devices

The rising use of mechanical circulatory support devices, particularly the Impella percutaneous microaxial flow pump, has become increasingly prevalent in cardiovascular practice for various purposes including hemodynamic support and organ protection. Despite their growing popularity, concerns exist due to limited randomized clinical trial data and potential complications such as vascular issues, cardiac perforations, and stroke, necessitating further research and upcoming trials to evaluate their safety and efficacy.

Impella ECMO

ECMO and Impella Support Strategies as a Bridge to Surgical Repair of Post-Infarction Ventricular Septal Rupture

This review evaluates the use of Impella and venoarterial extracorporeal membranous oxygenation (VA-ECMO) as strategies to stabilize patients with post-infarct ventricular septal rupture (PIVSR) before surgical repair, based on a case report and a systematic literature review. While both Impella and VA-ECMO have shown better outcomes compared to traditional management, they present unique advantages and challenges; Impella effectively unloads the left ventricle but may cause shunt reversal, whereas VA-ECMO improves organ perfusion but has higher complication risks and may require additional ventricular unloading.

Impella Image

Modelling and Simulation of the Combined Use of IABP and Impella as a Rescue Procedure in Cardiogenic Shock: An Alternative for Non-Transplant Centres?

This paper investigates the synergistic effect of combining the Intra-Aortic Balloon Pump (IABP) and Impella 2.5 device as mechanical circulatory support in managing cardiogenic shock. Using a cardiovascular system simulator, it demonstrates that this combined approach offers better support in the acute phase of cardiogenic shock than using either device alone, potentially stabilizing patients for transfer to a transplant center.

Heart Failute

Test Bench for Right Ventricular Failure Reversibility: The Hybrid BiVAD Concept

Patients with biventricular cardiogenic shock, ineligible for heart transplantation, may benefit from a micro-invasive hybrid BiVAD approach, combining the ProtekDuo cannula and the Impella 5.5 trans-aortic pump. This strategy, beyond ECMO, allows for physiological circulation, biventricular unloading, and accurate evaluation of right ventricular function, leading to the possibility of transitioning to less invasive, durable left ventricular assist device (LVAD) implantation.


Post Categories