A Nonocclusive, Inexpensive Pediatric Pulsatile Roller Pump for Cardiopulmonary Bypass, Extracorporeal Life Support, and Left/Right Ventricular Assist Systems

2013 ◽  
Vol 37 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Shigang Wang ◽  
Yves Durandy ◽  
Allen R. Kunselman ◽  
Akif Ündar
Keyword(s):  
Cardiopulmonary Bypass ◽  
Right Ventricular ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Roller Pump ◽  
Ventricular Assist

Rescue extracorporeal life support as a bridge to durable left ventricular assist device

2021 ◽  
pp. 039139882110538
Author(s):  
Alina Zubarevich ◽  
Konstantin Zhigalov ◽  
Marcin Szczechowicz ◽  
Arian Arjomandi Rad ◽  
Robert Vardanyan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Left Ventricular ◽  
Organ Function ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Background: The ideal timing of a durable assist device implantation in patients with end-stage heart failure presenting with INTERMACS profile I is still controversial. The data on extracorporeal life support (ECLS) bridge to durable left ventricular assist device (LVAD) in these patients is limited. Materials and methods: We retrospectively analyzed the outcomes of 35 patients in acute cardiogenic shock (CS) who, between December 2013 and September 2020, were bridged with ECLS to durable LVAD. The mean age was 52.3 ± 12.0 years. The primary endpoints of this study were in-hospital, 30-day, 6-month, and 1-year mortality. The secondary endpoint was the development of any postoperative adverse events and other characteristics during the follow-up period. We also assessed the impact of the rescue ECLS on the recovery of the end-organ function. Results: In-hospital, 30-day, 6-month, and 1-year survival was 65.6%, 75.9%, 69.2%, and 62.7% respectively. The median time on ECLS was 7 days (IQR 5.0–13.0). We observed a high incidence of a severe right heart failure (22.9%), acute kidney injury on dialysis (68.6%), and respiratory failure (77.1%). Bridge with ECLS provided a significant recovery of liver and kidney function prior to durable LVAD implantation. Conclusion: The concept of bridging patients presenting in end-stage heart failure and cardiogenic shock with ECLS prior to durable LVAD implantation is a feasible method to ensure acceptable survival rates and significant recovery of the end-organ function.

Extracorporeal Life Support: A Simple and Effective Weapon for Postcardiotomy Right Ventricular Failure

2009 ◽  
Vol 33 (7) ◽  
pp. 504-508 ◽  
Author(s):  
Kuo-Sheng Liu ◽  
Feng-Chun Tsai ◽  
Yao-Kuang Huang ◽  
Mon-Yue Wu ◽  
Yu-Sheng Chang ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Right Ventricular Failure ◽  
Ventricular Failure

Abstract 16064: Mechanical Left Ventricular Venting is Associated With Improved Survival in Adults Undergoing Venoarterial Extracorporeal Life Support: An ELSO Registry Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jose I Nunez ◽  
Brooks Willar ◽  
Kevin Kennedy ◽  
Peter Rycus ◽  
Joseph Tonna ◽  
...  
Keyword(s):  
Adverse Events ◽  
Renal Injury ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Limb Ischemia ◽  
Aortic Disease ◽  
Left Ventricular ◽  
Ventricular Assist ◽  
Clinical Covariates ◽  
Central Cannulation

Introduction: Venoarterial extracorporeal life support (VA-ECLS) imposes increased afterload on the left ventricle (LV), potentially provoking LV distension and impaired ventricular recovery. Prior studies have suggested a survival benefit with LV mechanical venting (MV), but multi-center data are lacking. Methods: We queried the ELSO registry for adults undergoing VA-ECLS and stratified them by the use of MV, including intra-aortic balloon pump and percutaneous ventricular assist device. We excluded patients with pulmonary embolism, heart transplant, congenital and valvular heart disease, aortic disease, and central cannulation. The primary outcome was in-hospital mortality. Secondary outcomes were on-support mortality and major adverse events, including bleeding, hemolysis, ischemic stroke, limb ischemia, and renal injury. We used multivariable logistic regression modeling to adjust for relevant clinical covariates. Results: Among 12734 patients undergoing VA-ECLS, 3353 (26.3%) received MV devices. Patients with MV were older (mean age 56.3 vs 52.7 years), more often male (76.3% vs 68.5%), and more often supported for acute myocardial infarction (43.0% vs 21.7%), p<0.001 for all. Prior to ECLS, patients with MV had lower rates of cardiac arrest (51.7% vs 55.1%) but more commonly needed >2 vasopressors (41.8% vs 27.2%) and had a higher incidence of acute renal (17.1% vs 10.5%), liver (4.4% vs 3.1%), and respiratory failure (20.9% vs 15.9%), p<0.001 for all. Crude on-support (41.6% vs 47.8%, p<0.001) and in-hospital (56.7% vs 59.2%, p=0.01) mortality were lower in the MV group. In multivariable modeling, MV was associated with a significantly lower odds of mortality but higher odds of adverse events including medical and cannula site bleeding, hemolysis, limb ischemia and renal injury (Figure). Conclusions: Among adults supported with peripheral VA-ECLS, LV MV was associated with lower mortality despite a higher rate of important adverse events.

Blood Platelet Activation and Membrane Glycoprotein Changes during Extracorporeal Life Support (Ecls). In Vitro Studies

1995 ◽  
Vol 18 (6) ◽  
pp. 315-321 ◽  
Author(s):  
K. Mellgren ◽  
L.G. Friberg ◽  
T. Hedner ◽  
G. Mellgren ◽  
H. Wadenvik
Keyword(s):  
Centrifugal Pump ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Membrane Receptors ◽  
Receptor Protein ◽  
Roller Pump ◽  
Platelet Surface ◽  
Continuous Increase ◽  
Significant Difference

The aim of this study was to evaluate an in vitro model for investigation of platelet function parameters in an extracorporeal system. Two different perfusion pumps were compared, a roller pump (Polystan) and a centrifugal pump (Biomedicus). A continuous increase in glycoprotein (GP)1b-negative platelets was observed in both circuits. A marked increase of plasma β-thromboglobulin thromboglobulin concentration and a decrease of the intracellular pool of serotonin was observed, indicating a marked release of alpha as well as of dense granules. The plasma concentration of glycocalicin increased in parallel with a reduced platelet surface expression of GP1b, suggesting that the loss of GP1b is caused by proteolysis rather than by a downregulation of this receptor protein. It is concluded that ECLS results in a pronounced platelet degranulation and causes changes of important membrane receptors which might explain some of the bleeding problems observed in patients treated with ECLS. No significant difference was noted between the roller pump and the centrifugal pump. Trial of strategies, e.g. protease inhibitors and nitric oxide to revert this untoward effect of ECLS are highly warranted.

scholarly journals Comparison of temporary ventricular assist devices and extracorporeal life support in post-cardiotomy cardiogenic shock

2018 ◽  
Vol 27 (6) ◽  
pp. 863-869 ◽  
Author(s):  
Prashant N Mohite ◽  
Anton Sabashnikov ◽  
Achim Koch ◽  
Raj Binu ◽  
Ashok Padukone ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices
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