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Review
. 2016 Mar 16:20:66.
doi: 10.1186/s13054-016-1235-3.

Mechanical circulatory support in the new era: an overview

Kiran Shekar  1   2 , Shaun D Gregory  3   4 , John F Fraser  3   4
Affiliations
Review

Mechanical circulatory support in the new era: an overview

Kiran Shekar et al. Crit Care. .

Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

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Figures

Fig. 1
Fig. 1
Cannulation sites for venoarterial extracorporeal membrane oxygenation (VA-ECMO). VA-ECMO can be instituted (a) centrally by cannulating the right atrium/inferior vena cava and the aorta, or peripherally using (b) femoral vein and femoral artery (dark blue arrow arterial return cannula, light blue arrow back flow cannula for distal limb perfusion), or (c) axillary/subclavian artery. The choice is often guided by the clinical setting, expected duration of support and pulmonary function. From [3] with permission
Fig. 2
Fig. 2
Temporary biventricular support strategies. a Biventricular assist and oxygenation support using two centrifugal pumps. Cannulation details: transfemoral right atrium (RA) drainage → allograft to pulmonary artery (PA) for returning oxygenated blood; and left ventricle (LV) apex drainage to aorta return. An oxygenator was included in the right ventricular assist device circuit. b Biventricular and oxygenation support provided using a single centrifugal pump. Dual drainage cannulas positioned in the LV apically and right atrium transfemorally. Oxygenated blood was returned to the ascending aorta through central cannulation. Insert demonstrates how the two drainage tubes were merged using a Y-connector to enable usage of a single pump
Fig. 3
Fig. 3
Schematic representation of two commercially available percutaneous ventricular assist devices. a the TandemHeart pVAD (Cardiac Assist Inc., Pittsburgh, PA, USA), b the Impella pVAD (AbioMed Europe, Aachen, Germany). From [53] with permission
Fig. 4
Fig. 4
Two commonly used rotary ventricular assist devices (VADs). a Thoratec HeartMate II, b HeartWare HVAD
See this image and copyright information in PMC

References

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