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Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
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How to Optimize ECLS Results beyond Ventricular Unloading: From ECMO to CentriMag® eVAD

Vincenzo Tarzia1, Lorenzo Bagozzi1, Matteo Ponzoni1

  • 1Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35122 Padova, Italy.

Journal of Clinical Medicine
|August 12, 2022
PubMed

Insights

CentriMag extracorporeal VAD offers a more physiological approach than ECMO for cardiogenic shock. This VAD improved survival rates and provided longer support compared to ECMO in high-flow scenarios.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Primary cardiogenic shock requires immediate circulatory support.
  • Conventional Extracorporeal Membrane Oxygenation (ECMO) is a standard treatment.
  • CentriMag extracorporeal Ventricular Assist Device (VAD) offers a potentially more physiological alternative.

Purpose of the Study:

  • To compare the outcomes of CentriMag extracorporeal VAD versus conventional ECMO in patients with primary cardiogenic shock.
  • To evaluate the impact of device selection on survival and support duration.

Main Methods:

  • Retrospective review of 212 patients with primary cardiogenic shock treated with extracorporeal life support (January 2009-December 2018).
  • Comparison between patients treated exclusively with ECMO (n=143) and those with extracorporeal VAD implantation (n=69).
  • Analysis of extracorporeal life support duration, highest predicted flow rates, and in-hospital/overall mortality.

Main Results:

  • Extracorporeal VAD support duration was significantly longer (14.25 days) than ECMO (8.37 days) (p=0.001).
  • Mean highest predicted flow rates were higher with extracorporeal VAD (79.49%) compared to ECMO (61.21%) (p=0.001).
  • Increasing mechanical support flow correlated with mortality in ECMO patients but not in extracorporeal VAD patients, with higher survival in the VAD group (p=0.027).

Conclusions:

  • CentriMag extracorporeal VAD provides longer and higher-flow mechanical circulatory support compared to ECMO in primary cardiogenic shock.
  • Extracorporeal VAD implantation is associated with improved survival, particularly in high-flow support scenarios.
  • CentriMag extracorporeal VAD represents a more physiological and effective option for managing primary cardiogenic shock.

Keywords:
ECMOLVADextracorporeal VADleft ventricle unloading

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