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Review
. 2024 May 28;13(11):3161.
doi: 10.3390/jcm13113161.

Mechanical Circulatory Support Devices in Patients with High-Risk Pulmonary Embolism

Rama Ellauzi  1 , Saliha Erdem  2 , Mohammad Fahad Salam  3 , Ashish Kumar  4 , Vikas Aggarwal  5 , Gerald Koenig  5 , Herbert D Aronow  5 , Mir Babar Basir  5
Affiliations
Review

Mechanical Circulatory Support Devices in Patients with High-Risk Pulmonary Embolism

Rama Ellauzi et al. J Clin Med. .

Abstract

Pulmonary embolism (PE) is a common acute cardiovascular condition. Within this review, we discuss the incidence, pathophysiology, and treatment options for patients with high-risk and massive pulmonary embolisms. In particular, we focus on the role of mechanical circulatory support devices and their possible therapeutic benefits in patients who are unresponsive to standard therapeutic options. Moreover, attention is given to device selection criteria, weaning protocols, and complication mitigation strategies. Finally, we underscore the necessity for more comprehensive studies to corroborate the benefits and safety of MCS devices in PE management.

Keywords: massive pulmonary embolism; mechanical circulatory support device; right ventricular assist device.

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Conflict of interest statement

Mir Babar Basir is a consultant for Abiomed, Boston Scientific, Cardiovascular Systems, Saranas and Zoll. All other authors have no conflicts of interest or disclosures.

Figures

Figure 1
Figure 1
Pathophysiology of the changes that occur during a high-risk pulmonary embolism. RV, right ventricular; LV left ventricular (Created with BioRender.com).
Figure 2
Figure 2
Cascading event occurring after pulmonary embolism. CVP, central venous pressure; LV, left ventricular; RV, right ventricular; RV-MCS, right ventricular mechanical circulatory support; RVEDP, right ventricular end-diastolic pressure; SIRS; Systemic Inflammatory Response Syndrome.
Figure 3
Figure 3
Right ventricular mechanical circulatory support devices can be used in high-risk pulmonary embolism. (Created with BioRender.com).
Figure 4
Figure 4
Pressure–volume changes that occur to the right and left ventricular with the use of right ventricular assist devices in high-risk pulmonary embolism.
Figure 5
Figure 5
Pressure–volume changes that occur to the right and left ventricular with the use of extracorporeal membrane oxygenation in high-risk pulmonary embolism.
See this image and copyright information in PMC

References

    1. Previtali E., Bucciarelli P., Passamonti S.M., Martinelli I. Risk factors for venous and arterial thrombosis. Blood Transfus. 2011;9:120–138. doi: 10.2450/2010.0066-10. - DOI - PMC - PubMed
    1. Bagot C.N., Arya R. Virchow and his triad: A question of attribution. Br. J. Haematol. 2008;143:180–190. doi: 10.1111/j.1365-2141.2008.07323.x. - DOI - PubMed
    1. Jaff M.R., McMurtry M.S., Archer S.L., Cushman M., Goldenberg N., Goldhaber S.Z., Jenkins J.S., Kline J.A., Michaels A.D., Thistlethwaite P., et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: A scientific statement from the American Heart Association. Circulation. 2011;123:1788–1830. doi: 10.1161/CIR.0b013e318214914f. - DOI - PubMed
    1. Konstantinides S.V., Meyer G., Becattini C., Bueno H., Geersing G.J., Harjola V.P., Huisman M.V., Humbert M., Jennings C.S., Jimenez D., et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) Eur. Heart J. 2020;41:543–603. doi: 10.1093/eurheartj/ehz405. - DOI - PubMed
    1. Giri J., Sista A.K., Weinberg I., Kearon C., Kumbhani D.J., Desai N.D., Piazza G., Gladwin M.T., Chatterjee S., Kobayashi T., et al. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association. Circulation. 2019;140:e774–e801. doi: 10.1161/CIR.0000000000000707. - DOI - PubMed

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