ArticleThe Journal of thoracic and cardiovascular surgery2023
Clinical efficacy of direct or indirect left ventricular unloading during venoarterial extracorporeal membrane oxygenation for primary cardiogenic shock.
Article in The Journal of thoracic and cardiovascular surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Impact of left ventricular unloading timing on clinical outcomes in venoarterial extracorporeal membrane oxygenation: an updated systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Early left ventricular unloading during extracorporeal membrane oxygenation in cardiogenic shock: A systematic review and meta-analysis.Artificial organs · 2025Pooled it
- Efficacy of venoarterial extracorporeal membrane oxygenation with and without intra-aortic balloon pump in adult cardiogenic shock.Frontiers in cardiovascular medicine · 2024Pooled it
- Comparison of the Efficacy of ECMO With or Without IABP in Patients With Cardiogenic Shock: A Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Thrombotic mitral valve obstruction during venoarterial extracorporeal membrane oxygenation with left ventricular venting following complex valve surgery.Journal of cardiothoracic surgery · 2026Article
- Impact of concomitant intra-aortic balloon pump support on outcomes in patients with acute myocardial infarction-related cardiogenic shock undergoing percutaneous coronary intervention with veno-arterial ECMO: a propensity-matched analysis.BMC cardiovascular disorders · 2026Article
- Rare Intraoperative Left Coronary Artery Dissection in Acute Type A Aortic Dissection: VA-ECMO-Assisted Coronary Artery Bypass Grafting.Clinical case reports · 2025Article
- Left ventricular unloading in patients with cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation.European heart journal open · 2025Article
- Left ventricle unloading during veno-arterial extracorporeal membrane oxygenation: review with updated evidence.Acute and critical care · 2024Article
- Different strategies in left ventricle unloading during venoarterial extracorporeal membrane oxygenation: A network meta-analysis.International journal of cardiology. Heart & vasculature · 2024Review
- 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 challenge of advanced therapies in the contemporary era: first in Europe ECPELLA long-distance transfer-a case report.European heart journal. Case reports · 2024Article
- Differential effect of left ventricular unloading according to the aetiology of cardiogenic shock.ESC heart failure · 2024Observational
- Perspectives and Considerations of IABP in the Era of ECMO for Cardiogenic Shock.Advances in therapy · 2023Review
- A case of fulminant myocarditis with full recovery after a 38-h sustained asystole.Clinical case reports · 2023Article
- Impella Versus VA-ECMO for Patients with Cardiogenic Shock: Comprehensive Systematic Literature Review and Meta-Analyses.Journal of cardiovascular development and disease · 2023Review
- Left Ventricular Unloading in Patients on Venoarterial Extracorporeal Membrane Oxygenation Therapy in Cardiogenic Shock: Prophylactic Versus Bail-Out Strategy.Life (Basel, Switzerland) · 2023Article
- Optimising the ECMO treatment regimen increases the survival rate for adult patients with acute fulminant myocarditis: A single-centre retrospective cohort study.Frontiers in medicine · 2023Article
- Benefits of Intra-Aortic Balloon Pump Support in Patients with Postcardiotomy Shock Requiring Venoarterial Extracorporeal Membrane Oxygenation.Life (Basel, Switzerland) · 2022Article
- Cardiac Surgery in Advanced Heart Failure.Journal of clinical medicine · 2022Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveLeft ventricular (LV) distention is a feared complication in patients receiving venoarterial (VA) extracorporeal membrane oxygenation (ECMO). LV unloading can be achieved indirectly with intra-aortic balloon pump (IABP) or directly with an Impella device (Abiomed, Danvers, Mass). We sought to assess the clinical and hemodynamic effects of IABP and Impella devices on patients supported with VA ECMO.
methodsWe conducted a retrospective review of VA ECMO patients at our institution from January 2015 to June 2020. Patients were categorized as either ECMO alone or ECMO with LV unloading. LV unloading was characterized as either ECMO with IABP or ECMO with Impella. We recorded baseline characteristics, survival, complications, and hemodynamic changes associated with device initiation.
resultsDuring the study, 143 patients received ECMO alone whereas 140 received ECMO with LV unloading (68 ECMO with IABP, 72 ECMO with Impella). ECMO with Impella patients had a higher incidence of bleeding events compared with ECMO alone or ECMO with IABP (52.8% vs 37.1% vs 17.7%; P < .0001). Compared with ECMO alone, ECMO with IABP patients had better survival at 180 days (log rank P = .005) whereas survival in ECMO with Impella patients was not different (log rank P = .66). In a multivariable Cox hazard analysis, age (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = .015), male sex (HR, 0.54; 95% CI, 0.38-0.80; P = .002), baseline lactate (HR, 1.06; 95% CI, 1.02-1.11; P = .004), baseline creatinine (HR, 1.06; 95% CI, 1.00-1.11; P = .032), need for extracorporeal membrane oxygenation-cardiopulmonary resuscitation (HR, 2.09; 95% CI, 1.40-3.39; P = .001), and presence of pre-ECMO IABP (HR, 0.45; 95% CI, 0.25-0.83; P = .010) were associated with reduced mortality. There was no significant difference in hemodynamic changes in the ECMO with IABP versus ECMO with Impella cohorts.
conclusionsConcomitant support with IABP might help reduce morbidity and improve 180-day survival in patients receiving VA ECMO for cardiogenic shock.
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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.