ArticleEuropean heart journal supplements : journal of the European Society of Cardiology2021
Left ventricular unloading and the role of ECpella.
Article in European heart journal supplements : journal of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 45 citations in OpenAlex.
- Left Ventricular Failure Despite Patent Coronary Arteries in Acute Type A Aortic Dissection.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Short-Term Percutaneous Mechanical Circulatory Support in Acute Coronary Syndrome with Cardiogenic Shock: Which Device to Choose?Journal of cardiovascular development and disease · 2026Review
- Respiratory Support in Cardiogenic Pulmonary Edema: Clinical Insights from Cardiology and Intensive Care.Journal of cardiovascular development and disease · 2026Review
- ECPELLA as a Bridge to Unexpected Myocardial Recovery in a Patient in Refractory Cardiogenic Shock.JACC. Case reports · 2025Article
- Harlequin Syndrome in Venoarterial ECMO and ECPELLA: When ECMO and Native or Impella Circulations Collide - A Comprehensive Review.Reviews in cardiovascular medicine · 2025Review
- Transaortic Catheter Venting for Left Ventricular Unloading in Veno-Arterial Extracorporeal Life Support: A Porcine Cardiogenic Shock Model.Medicina (Kaunas, Lithuania) · 2025Article
- Variability in triggers for mechanical left ventricular unloading in VA-ECMO: A literature search.The journal of extra-corporeal technology · 2025Review
- Left ventricle unloading during veno-arterial extracorporeal membrane oxygenation: review with updated evidence.Acute and critical care · 2024Article
- Investigations of Differential Hypoxemia During Venoarterial Membrane Oxygenation with and Without Impella Support.Cardiovascular engineering and technology · 2024Article
- Article
- The Management of Cardiogenic Shock From Diagnosis to Devices: A Narrative Review.CHEST critical care · 2024Article
- ECPELLA as a bridge-to-decision in refractory cardiogenic shock: a single-centre experience.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2024Article
- Impact of Left Ventricular Unloading on Outcome of Heart Transplant Bridging With Extracorporeal Membrane Oxygenation Support in New Allocation Policy.Journal of the American Heart Association · 2024Article
- The physiology of venoarterial extracorporeal membrane oxygenation - A comprehensive clinical perspective.Perfusion · 2024Review
- Concomitant use of extracorporeal membrane oxygenation and percutaneous microaxial assist device support for cardiogenic shock.JTCVS open · 2024Article
- Mechanical circulatory support in cardiogenic shock.Journal of intensive care · 2023Review
- Extracorporeal Membrane Oxygenation for Septic Shock in Adults and Children: A Narrative Review.Journal of clinical medicine · 2023Review
- Growing Evidence for LV Unloading in VA ECMO.Journal of clinical medicine · 2023Review
- Early left ventricular unloading after extracorporeal membrane oxygenation: rationale and design of EARLY-UNLOAD trial.ESC heart failure · 2023Article
- Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The main reason for the emergency implantation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is the restoration of adequate systemic perfusion, while protecting the failing heart and promoting myocardial recovery are equally important goals. Following initial haemodynamic stabilization and often the urgent revascularization of the culprit lesion, the clinical focus is then directed towards the most efficient strategy for cardioprotection. Frequent echocardiography measurements may help to estimate the degree of unwanted left ventricular (LV) overloading during VA-ECMO. Additionally, the estimation of high LV filling pressures by Doppler echocardiography or their (in-)direct measurement using a dedicated surgical left atrial pressure line and conventional pulmonary artery catheter in a wedge position or a pigtail catheter in the left ventricle can be performed. Mechanical overload of the left ventricle is the major adverse effect and an obvious mechanistic and prognostic challenge of contemporary ECMO care. Many efforts are under way to overcome this phenomenon by LV unloading, which was effectively achieved by the current combined approach using an axial decompression device, while novel technical developments and approaches are tested and urgently anticipated. The aim of this report is to introduce in depth pathophysiological background, current concepts, and future perspectives in LV unloading strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.