Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts
Abstract Temporary mechanical circulatory support (MCS), including veno-arterial extracorporeal membrane oxygenation (ECMO) and micro-axial pumps (Impella), is increasingly used in clinical practice for refractory circulatory failure. Complex physiological responses to each technique or their combin...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-06457-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849238261903392768 |
|---|---|
| author | Konstantin Yastrebov Hugh S. Paterson David H. Tian Laurencie M. Brunel Fiona C. Schnitzler Lisa M. Partel Mark Dennis Paul G. Bannon |
| author_facet | Konstantin Yastrebov Hugh S. Paterson David H. Tian Laurencie M. Brunel Fiona C. Schnitzler Lisa M. Partel Mark Dennis Paul G. Bannon |
| author_sort | Konstantin Yastrebov |
| collection | DOAJ |
| description | Abstract Temporary mechanical circulatory support (MCS), including veno-arterial extracorporeal membrane oxygenation (ECMO) and micro-axial pumps (Impella), is increasingly used in clinical practice for refractory circulatory failure. Complex physiological responses to each technique or their combination (ECPELLA) remain debated and are often specific to cardiovascular pathology. A paucity of data on physiological responses to MCS in normal subjects makes comprehensive understanding of such responses in variable disease states difficult, as well as during weaning MCS in recovering hearts. This translational investigation compared three MCS techniques with variable pump flows in healthy sheep (n = 7) to establish baseline for future studies in cardiomyopathic models. All MCS techniques increased arterial elastance, but reduced LV myocardial work, coronary arterial flow and LV myocardial oxygen consumption. ECPELLA was more effective in increasing total systemic blood flow and MAP. The overall similarity between the MCS techniques suggests that the more invasive and complex combination of devices (ECPELLA) can only be justified for management of the severe failing heart as the means for decompressing LV. A study investigating the comparative impacts of different regimes and MCS techniques in a cardiomyopathic model is warranted. |
| format | Article |
| id | doaj-art-e77f34548a3844b59d7a47a5e541ef98 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-e77f34548a3844b59d7a47a5e541ef982025-08-20T04:01:41ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-06457-0Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine heartsKonstantin Yastrebov0Hugh S. Paterson1David H. Tian2Laurencie M. Brunel3Fiona C. Schnitzler4Lisa M. Partel5Mark Dennis6Paul G. Bannon7Prince of Wales HospitalThe University of SydneyWestmead HospitalThe University of SydneyThe University of SydneyThe University of SydneyThe University of SydneyThe University of SydneyAbstract Temporary mechanical circulatory support (MCS), including veno-arterial extracorporeal membrane oxygenation (ECMO) and micro-axial pumps (Impella), is increasingly used in clinical practice for refractory circulatory failure. Complex physiological responses to each technique or their combination (ECPELLA) remain debated and are often specific to cardiovascular pathology. A paucity of data on physiological responses to MCS in normal subjects makes comprehensive understanding of such responses in variable disease states difficult, as well as during weaning MCS in recovering hearts. This translational investigation compared three MCS techniques with variable pump flows in healthy sheep (n = 7) to establish baseline for future studies in cardiomyopathic models. All MCS techniques increased arterial elastance, but reduced LV myocardial work, coronary arterial flow and LV myocardial oxygen consumption. ECPELLA was more effective in increasing total systemic blood flow and MAP. The overall similarity between the MCS techniques suggests that the more invasive and complex combination of devices (ECPELLA) can only be justified for management of the severe failing heart as the means for decompressing LV. A study investigating the comparative impacts of different regimes and MCS techniques in a cardiomyopathic model is warranted.https://doi.org/10.1038/s41598-025-06457-0ImpellaECMOECPELLAHemodynamicsMyocardial workMyocardial oxygen consumption |
| spellingShingle | Konstantin Yastrebov Hugh S. Paterson David H. Tian Laurencie M. Brunel Fiona C. Schnitzler Lisa M. Partel Mark Dennis Paul G. Bannon Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts Scientific Reports Impella ECMO ECPELLA Hemodynamics Myocardial work Myocardial oxygen consumption |
| title | Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts |
| title_full | Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts |
| title_fullStr | Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts |
| title_full_unstemmed | Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts |
| title_short | Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts |
| title_sort | head to head comparison of v a ecmo impella and ecpella in normal ovine hearts |
| topic | Impella ECMO ECPELLA Hemodynamics Myocardial work Myocardial oxygen consumption |
| url | https://doi.org/10.1038/s41598-025-06457-0 |
| work_keys_str_mv | AT konstantinyastrebov headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT hughspaterson headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT davidhtian headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT laurenciembrunel headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT fionacschnitzler headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT lisampartel headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT markdennis headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts AT paulgbannon headtoheadcomparisonofvaecmoimpellaandecpellainnormalovinehearts |