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Updated: Jun 6, 2026
07:39
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
A Progressive Mobilization Protocol for Surgically Implanted Temporary Ventricular Assist Devices: A Retrospective
1From the Cardiovascular Institute, Allegheny Health Network, Pittsburgh, Pennsylvania.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|June 5, 2026
Summary
A structured mobilization protocol for patients with axillary percutaneous ventricular assist devices (pVADs) significantly improved functional status and clinical outcomes. Early and progressive exercise is feasible and beneficial for recovery, durable LVAD implantation, and heart transplantation.
Area of Science:
- Cardiology
- Mechanical Circulatory Support
- Rehabilitation Medicine
Background:
- Axillary percutaneous ventricular assist devices (pVADs) are vital for refractory cardiogenic shock.
- Standardized mobilization protocols for axillary pVAD patients are currently lacking.
- Early mobilization can improve outcomes in critically ill patients.
Purpose of the Study:
- To describe and evaluate a structured, progressive, multidisciplinary mobilization protocol for patients with axillary pVADs.
- To assess the impact of this protocol on functional status and clinical outcomes.
- To determine the feasibility and safety of early mobilization in this patient population.
Main Methods:
- A cohort of 196 patients with axillary pVADs was analyzed from December 2020 to June 2025.
- 131 patients (67%) underwent a structured, progressive mobilization protocol.
- Functional status was assessed using Johns-Hopkins Highest Level of Mobility (JH-HLM) scores; clinical outcomes were tracked.
Main Results:
- Mobilized patients showed significantly higher JH-HLM scores at ICU and hospital discharge (p < 0.001, p = 0.002).
- Stepwise improvement in JH-HLM scores was observed across mobilization sessions (p < 0.001).
- The mobilized group had lower mortality (12% vs. 58%) and higher rates of recovery, durable LVAD, and heart transplantation (p < 0.001).
Conclusions:
- A structured mobilization protocol is feasible and safe for patients with axillary pVAD support.
- This protocol leads to progressive improvements in functional status.
- Early and structured mobilization is associated with superior clinical outcomes, including survival and device support options.
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