ArticleBioengineering (Basel, Switzerland)2025
Increased VA-ECMO Pump Speed Reduces Left Atrial Pressure: Insights from a Novel Biventricular Heart Model.
Article in Bioengineering (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Baseline Ventricular-Arterial Coupling Modifies Left Atrial Pressure Response to Venoarterial Extracorporeal Membrane Oxygenation In Vitro.Artificial organs · 2026Article
- Comparison of Left Ventricular Pressure-Volume Loops With Veno-Arterial Extracorporeal Membrane Oxygenator Support: In Vitro Investigation.Artificial organs · 2026Article
- Hemi-ECMO: A Novel Method of Left Ventricular Afterload Reduction for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO).Bioengineering (Basel, Switzerland) · 2026Article
- Review of Cardiovascular Mock Circulatory Loop Designs and Applications.Bioengineering (Basel, Switzerland) · 2025Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThe effect of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) on left atrial pressure (LAP) in the presence of interventricular interaction and the Frank-Starling mechanism is unknown. We developed and validated a mock circulatory loop (MCL) incorporating a novel, 3D-printed biventricular heart model and Frank-Starling algorithm, and used this model to assess the determinants of LAP during VA-ECMO support.
methodsThe MCL was designed to allow a separate ventricle or biventricular configuration, with or without an active Frank-Starling mechanism. The biventricular model with Frank-Starling mechanism was validated in terms of (1) the presence and degree of ventricular interactions; (2) its ability to simulate Frank-Starling physiology; and (3) its capacity to simulate normal and pathological cardiac states. In the separate ventricle and biventricular with Frank-Starling models, we assessed the effect on LAP of changes in mean aortic pressure (mAoP), ECMO pump speed, LV contractility and ECMO return flow direction.
resultsIn the biventricular configuration, clamping RA inflow decreased RAP, with a concurrent decrease in LAP, consistent with direct ventricular interaction. With a programmed Frank-Starling mechanism, decreasing RAP was associated with a significant reduction in both LV outflow and LV end-systolic pressure. In the biventricular model with a Frank-Starling algorithm, the MCL was able to reproduce pre-defined normal and pathological cardiac output, and arterial and ventricular pressures. Increasing aortic pressure caused a linear increase in LAP in the separate ventricle model, which was attenuated in the biventricular model with Frank-Starling mechanism. Increasing ECMO pump speed caused no change in LAP in the separate ventricle model (
conclusionsInterventricular interactions and the Frank-Starling mechanism can be simulated in a physical, biventricular MCL. In their presence, the effects of VA-ECMO on LAP are mitigated, with LAP reduction and stabilization at maximal VA-ECMO speeds.
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