Modalities and Effects of Left Ventricle Unloading on Extracorporeal Life support: a Review of the Current Literature

Veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature.

[1]  S. Blankenberg,et al.  Concomitant implantation of Impella® on top of veno‐arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock , 2017, European journal of heart failure.

[2]  R. Lorusso.  Are two crutches better than one? The ongoing dilemma on the effects and need for left ventricular unloading during veno‐arterial extracorporeal membrane oxygenation , 2017, European journal of heart failure.

[3]  J. Tijssen,et al.  Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. , 2017, Journal of the American College of Cardiology.

[4]  G. Whitman.  Extracorporeal membrane oxygenation for the treatment of postcardiotomy shock. , 2017, The Journal of thoracic and cardiovascular surgery.

[5]  N. Chou,et al.  Effects of Additional Intra-aortic Balloon Counter-Pulsation Therapy to Cardiogenic Shock Patients Supported by Extra-corporeal Membranous Oxygenation , 2016, Scientific Reports.

[6]  Peter A. Knight,et al.  Percutaneous Decompression of the Left Ventricle in Cardiogenic Shock Patients on Venoarterial Extracorporeal Membrane Oxygenation , 2016, Journal of cardiac surgery.

[7]  Y. Barnett,et al.  Spinal Cord Infarct During Concomitant Circulatory Support With Intra-Aortic Balloon Pump and Veno-Arterial Extracorporeal Membrane Oxygenation , 2016, Critical care medicine.

[8]  S. Chaparro,et al.  Incidence of Hemolysis in Patients with Cardiogenic Shock Treated with Impella Percutaneous Left Ventricular Assist Device , 2016, ASAIO journal.

[9]  J. Oh,et al.  Initial Experience of Transaortic Catheter Venting in Patients with Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock , 2015, ASAIO journal.

[10]  Antonio R. Fernandez,et al.  Part 2: Evidence Evaluation and Management of Conflicts of Interest: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. , 2015, Circulation.

[11]  Monique L. Anderson,et al.  Part 6: Alternative Techniques and Ancillary Devices for Cardiopulmonary Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. , 2015, Circulation.

[12]  P. Neužil,et al.  Increasing venoarterial extracorporeal membrane oxygenation flow negatively affects left ventricular performance in a porcine model of cardiogenic shock , 2015, Journal of Translational Medicine.

[13]  R. Cheng,et al.  Lack of Survival Benefit Found With Use of Intraaortic Balloon Pump in Extracorporeal Membrane Oxygenation: A Pooled Experience of 1517 Patients. , 2015, The Journal of invasive cardiology.

[14]  G. Wagener,et al.  Trans-diaphragmatic left ventricular venting during peripheral venous-arterial extracorporeal membrane oxygenation , 2015, Perfusion.

[15]  C. Brizard,et al.  Elective decompression of the left ventricle in pediatric patients may reduce the duration of venoarterial extracorporeal membrane oxygenation. , 2015, Artificial organs.

[16]  D. Kolte,et al.  Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Combination with Intra-Aortic Balloon Counterpulsation in Patients with Cardiovascular Compromise , 2014, Cardiology.

[17]  P. Leprince,et al.  Intra-Aortic Balloon Pump Effects on Macrocirculation and Microcirculation in Cardiogenic Shock Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation* , 2014, Critical care medicine.

[18]  M. Pilato,et al.  Extracorporeal Membrane Oxygenation for Graft Failure after Heart Transplantation: A Multidisciplinary Approach to Maximize Weaning Rate , 2014, The International journal of artificial organs.

[19]  S. K. Ro,et al.  Extracorporeal life support for cardiogenic shock: influence of concomitant intra-aortic balloon counterpulsation. , 2014, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[20]  T. Park,et al.  Clinical impact of intra-aortic balloon pump during extracorporeal life support in patients with acute myocardial infarction complicated by cardiogenic shock , 2014, BMC Anesthesiology.

[21]  Xiaojing Ma,et al.  Combining ECMO with IABP for the treatment of critically Ill adult heart failure patients. , 2014, Heart, lung & circulation.

[22]  M. Karck,et al.  Central extracorporeal life support with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure , 2014, Journal of Cardiothoracic Surgery.

[23]  M. Ono,et al.  Central extracorporeal membrane oxygenation requiring pulmonary arterial venting after near-drowning. , 2014, The American journal of emergency medicine.

[24]  Z. Wang,et al.  Effects of intra-aortic balloon pump on cerebral blood flow during peripheral venoarterial extracorporeal membrane oxygenation support , 2014, Journal of Translational Medicine.

[25]  Michael F Swartz,et al.  Impella to Unload the Left Ventricle During Peripheral Extracorporeal Membrane Oxygenation , 2013, ASAIO journal.

[26]  M. Karck,et al.  Extracorporeal life support with an integrated left ventricular vent in children with a low cardiac output * , 2013, Cardiology in the Young.

[27]  W. Aronow,et al.  Combination use of a TandemHeart with an extracorporeal oxygenator in the treatment of five patients with refractory cardiogenic shock after acute myocardial infarction. , 2013, American journal of therapeutics.

[28]  É. Marijon,et al.  Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program). , 2013, European heart journal.

[29]  A. Guerguerian,et al.  Left atrial decompression during venoarterial extracorporeal membrane oxygenation for left ventricular failure in children: current strategy and clinical outcomes. , 2013, Artificial organs.

[30]  G. Schuler,et al.  Intraaortic balloon support for myocardial infarction with cardiogenic shock. , 2012, The New England journal of medicine.

[31]  P. Leprince,et al.  Two-dimensional strain rate and Doppler tissue myocardial velocities: analysis by echocardiography of hemodynamic and functional changes of the failed left ventricle during different degrees of extracorporeal life support. , 2012, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[32]  W. Pae,et al.  Management of left ventricular distension during peripheral extracorporeal membrane oxygenation for cardiogenic shock , 2012, Perfusion.

[33]  Anson Cheung,et al.  Illustrated techniques for transapical aortic valve implantation. , 2012, Annals of cardiothoracic surgery.

[34]  M. Belohlavek,et al.  Coronary versus carotid blood flow and coronary perfusion pressure in a pig model of prolonged cardiac arrest treated by different modes of venoarterial ECMO and intraaortic balloon counterpulsation , 2012, Critical Care.

[35]  J. Moses,et al.  Impella LP 2.5 for Left Ventricular Unloading During Venoarterial Extracorporeal Membrane Oxygenation Support , 2011, Journal of cardiac surgery.

[36]  A. Barbone,et al.  Left ventricle unloading by percutaneous pigtail during extracorporeal membrane oxygenation. , 2011, Interactive cardiovascular and thoracic surgery.

[37]  U. Hoppe,et al.  The acute effect of IABP-induced pulsatility on coronary vascular resistance and graft flow in critical ill patients during ECMO. , 2011, The Journal of cardiovascular surgery.

[38]  V. Fouilloux,et al.  Extracorporeal membranous oxygenation and left atrial decompression: a fast and minimally invasive approach. , 2011, The Annals of thoracic surgery.

[39]  M. Ono,et al.  Left Ventricular Mechanical Support with Impella Provides More Ventricular Unloading in Heart Failure Than Extracorporeal Membrane Oxygenation , 2011, ASAIO journal.

[40]  R. Fumagalli,et al.  Percutaneous Left-Heart Decompression During Extracorporeal Membrane Oxygenation: An Alternative to Surgical and Transeptal Venting in Adult Patients , 2011, ASAIO journal.

[41]  K. Ejiri,et al.  Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest patients treated with cardiopulmonary resuscitation using extracorporeal life support. , 2010, Resuscitation.

[42]  A. Menkis,et al.  Minimally invasive left-heart decompression during venoarterial extracorporeal membrane oxygenation: an alternative to a percutaneous approach. , 2010, Interactive cardiovascular and thoracic surgery.

[43]  R. Kerber,et al.  Left heart decompression by atrial stenting during extracorporeal membrane oxygenation , 2009, The International journal of artificial organs.

[44]  R. Neumar,et al.  Consensus Process , 2022 .

[45]  N. Chi,et al.  Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis , 2008, The Lancet.

[46]  J. Maessen,et al.  The acute effect of intra-aortic balloon counterpulsation during extracorporeal life support: an experimental study. , 2007, Artificial organs.

[47]  A. Rocchini,et al.  Decompression of the left atrium during extracorporeal membrane oxygenation using a transseptal cannula incorporated into the circuit* , 2006, Critical care medicine.

[48]  B. Meyns,et al.  Ventricular unloading with a miniature axial flow pump in combination with extracorporeal membrane oxygenation , 2006, Intensive Care Medicine.

[49]  R. Fumagalli,et al.  Percutaneous Bridge to Heart Transplantation by Venoarterial ECMO and Transaortic Left Ventricular Venting , 2004, The International journal of artificial organs.

[50]  B. Kiaii,et al.  Five-year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock. , 2004, The Annals of thoracic surgery.

[51]  A. Redington,et al.  Percutaneous left ventricular “vent” insertion for left heart decompression during extracorporeal membrane oxygenation , 2003, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[52]  J. Fasules,et al.  Blade and balloon atrial septostomy for left heart decompression in patients with severe ventricular dysfunction on extracorporeal membrane oxygenation , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[53]  L. Golding.  Postcardiotomy mechanical support. , 1991, Seminars in thoracic and cardiovascular surgery.