The ProtekDuo veno-venous (V-V) dual lumen cannula provides extracorporeal mechanical circulatory support (MCS) with or without an oxygenator. When combined with a TandemHeart® pump, it can deliver ~4.5 liters/minute of flow by draining blood from the right atrium and returning it to the pulmonary artery (PA). This allows right side…
Mechanical circulatory support (MCS) devices allow us to offload myocardial work from the heart, and for the purposes of this post, the left ventricle (LV). Referring to my previous post on the work of breathing, we can extrapolate the same pressure-volume (PV) loop integral to represent work, except in this…
The Avalon bicaval catheter has revolutionized venovenous extracorporeal membrane oxygenation (VV-ECMO) by allowing us to place a single catheter that can simultaneously drain venous blood from the central circulation (superior and inferior vena cavas) to deliver oxygenated blood directly into the heart.
Impella® is a percutaneous axial heart pump placed retrograde across the aortic valve into the left ventricle (LV) utilizing fluoroscopy +/- echocardiography. Its indications include high-risk percutaneous coronary intervention (PCI, especially cardiogenic shock or signs of ongoing ischemia), post-cardiotomy failure, and myocarditis. In addition, it is routinely used as a…
The intra-aortic balloon pump (IABP) is a form of mechanical circulatory support used in cardiogenic shock, facilitating separation from cardiopulmonary bypass, percutaneous coronary interventions, unstable angina, and thrombolytic therapy following myocardial infarction. The device is introduced from the femoral artery and guided into the aorta until its tip is distal…
Ventricular assist devices (VADs) can support the right (RVAD) and left (LVAD) ventricles and were initially utilized as mechanical circulatory support devices for bridge-to-transplant (BTT) in heart failure. Modern continuous flow VADs are also being used for destination therapy (DT) for those who are not candidates for cardiac transplantation or are too ill to…