International Perfusion Association

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IPA

Category: VAD

LVAD

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.

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January 22, 2024
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.

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January 19, 2024
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.

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January 9, 2024
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.

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January 1, 2024
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.

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December 29, 2023

Artificial Intelligence-Based Analysis of Body Composition Predicts Outcome in Patients Receiving Long-Term Mechanical Circulatory Support

This study used artificial intelligence to analyze preoperative CT scans of heart failure patients receiving left ventricular assist device (LVAD) implantations, revealing that greater adipose tissue areas are associated with higher postoperative complications and in-hospital mortality. It concluded that preoperative body composition, particularly adipose tissue, can predict poorer outcomes post-LVAD implantation, impacting postoperative quality of life and walking distance.

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December 28, 2023

Mechanical Circulatory Support in Cardiogenic Shock

The abstract outlines the evolving management of cardiogenic shock, highlighting the transition to using temporary mechanical circulatory support (t-MCS) like IABP, VA-ECMO, Impella, and ECPELLA, informed by advances in circulatory physiology. It emphasizes the importance of selecting appropriate t-MCS devices based on patient-specific conditions, shock stage, and risk, guided by hemodynamic monitoring and a multidisciplinary team approach.

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December 26, 2023

A Multipurpose Extracorporeal Life Support Circuit: A Concept for Multiorgan Transplant and Circulatory Support Service Healthcare Provider

We propose the creation of a multipurpose circuit that integrates multiple extracorporeal life support (ECLS) functions to cater to diverse medical needs. This innovative circuit not only offers cost-effectiveness and enhanced safety but also ensures optimal utilization, thereby revolutionizing the realm of life support technologies.

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December 15, 2023

Clinical Indications and Outcomes of Impella Devices for Severe Cardiogenic Shock in COVID-19 Patients: A Systematic Review

Coronavirus disease 2019 (COVID-19) can present with significant cardiac dysfunction, including cardiogenic shock. Mechanical circulatory support with an Impella device may be utilized in these patients to support and offload native right ventricle (RV) and left ventricle (LV) functions. This systematic review aims to describe clinical indications, management, laboratory data, and outcomes in patients with severe cardiogenic shock from COVID-19 treated with an Impella device.

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December 15, 2023
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