Key result
MCS devices exert distinct hemodynamic and physiological effects based on mechanism, capacity, and insertion site.
Why the study?
Mechanical circulatory support devices differ in pumping mechanisms, flow capacities, insertion techniques, and blood flow sites, but these differences are not generally considered when selecting or managing devices for patients.
This review outlines the fundamental principles of cardiac, vascular, and pump mechanics to improve understanding of heart-device interactions and guide mechanical circulatory support selection.
An increasing number of devices can provide mechanical circulatory support (MCS) to patients with acute hemodynamic compromise and chronic end-stage heart failure. These devices work by different pumping mechanisms, have various flow capacities, are inserted by different techniques, and have different sites from which blood is withdrawn and returned to the body. These factors result in different primary hemodynamic effects and secondary responses of the body. However, these are not generally taken into account when choosing a device for a particular patient or while managing a patient undergoing MCS. In this review, we discuss fundamental principles of cardiac, vascular, and pump mechanics and illustrate how they provide a broad foundation for understanding the complex interactions between the heart, vasculature, and device, and how they may help guide future research to improve patient outcomes.
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Burkhoff et al. (2015) conducted a review in Acute hemodynamic compromise and chronic end-stage heart failure. Mechanical circulatory support (MCS) was evaluated. Mechanical circulatory support devices exhibit distinct primary hemodynamic effects and secondary physiological responses depending on their pumping mechanisms, flow capacities, and insertion sites.
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