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Printable Handouts
Navigable Slide Index
- Introduction
- Surgically placed temporary MCS
- Impella 5.0/5.5 ®
- CentriMag™
- VA-ECLS/VA ECMO central cannulation
- Management of heart failure cardiogenic shock
- Outcomes-tMCS to heart transplant
- Outcomes-tMCS to durable VAD
- Durable MCS
- Indications: class I
- Indications: class IIA
- Current types of devices for biventricular support
- EACTS recommendations
- Risk stratification class IIa acute cardiogenic shock
- HeartMate 3™ LVAD
- Continuous flow VAD parameters
- X-ray example
- Complications in LVAD patients
- Systematic approach to hypotension
- Challenges to RVADs
- RVAD + LVAD for BiV failure
- X-ray example (right and left)
- SynCardia temporary Total Artificial Heart
- Artificial heart
- SynCardia artificial heart
- Settings
- X-ray example (TAH)
- Aeson®, the CARMAT total artificial heart
- TAH vs. LVAD/BiVAD survival after transplant
- References
- Acknowledgements
Topics Covered
- Surgically placed temporary mechanical circulatory support (MCS)
- Management of heart failure cardiogenic shock
- Durable MCS
- Types of devices for biventricular support
- Systematic approach to hypotension
- Artificial heart
Links
Categories:
Therapeutic Areas:
External Links
Talk Citation
Presti, C.R. (2024, May 30). Types of mechanical circulatory support devices and their applications: durable and mechanical circulatory support devices [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 8, 2024, from https://doi.org/10.69645/PKVV8058.Export Citation (RIS)
Publication History
Financial Disclosures
- There are no commercial/financial matters to disclose.
Types of mechanical circulatory support devices and their applications: durable and mechanical circulatory support devices
Published on May 30, 2024
29 min
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:04
Shifting gears to
surgically placed
temporary mechanical
circulatory support.
0:12
We've talked about Impella,
but if we use a
larger introducer
sheath to house a
larger, a pigtail drain,
then these patients
are going to need
surgical cutdown for insertion.
Indications for the
Impella 5.0/5.5,
a high risk percutaneous
coronary intervention,
cardiogenic shock,
and these are placed femoral
most often and are going to
drain again the
left ventricle and
the outflow into the aorta
like the Impella CP,
but this Impella 5.0/5.5 handles
a larger amount of volume
at greater than five
liters per minute.
Recent studies indicate
improved mortality
with the use of the
Impella 5.0/5.5 higher flows
and higher cardiac output.
1:08
The CentriMag can be used for
left ventricular assist
device or it can be used for
biventricular support
as well. When it's
used with ECMO as a pump itself.
So, indications for the
CentriMag. Recently,
the indications were
somewhat widened with
temporary circulatory
support up to 30 days.
In Europe, it's been that
way for a few years,
but the FDA just
approved it recently
here in the States.
Placement is going
to be surgical via
sternotomy or
lateral thoracotomy.
The CentriMag can provide
support with a cannula placed
in the left atrium, inflow
then, and return to
the aorta up to about seven
to ten liters of flow.
If placed in the right ventricle,
then the inflow would be
right atrium and
the outflow would
be diverting to the
pulmonary artery.
The CentriMag uses
a magnetically levitated
extracorporeal
centrifugal flow pump
and often is used for
postcardiotomy patients
that are failure to
wean from bypass in
the operating room as a bridge
to recovery or a bridge
to decision and
survival is linked with
30-day survival of
41-60% after placement.
Contraindications, of
course, unable to be
anticoagulated and
complications, no surprise,
bleeding, acute renal
failure, and infection at
about 28% for each of
those complications.
We talked about VA ECMO
central cannulation.
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