Key result
The Pulsatile Ventricular Assist Platform in VA-ECMO (n=6 pigs) increased forward cardiac output without LV overload, and synchronized counter-pulsatile flow improved LV afterload vs no support.
Why the study?
Continuous-flow VA-ECMO temporarily maintains hemodynamics at the cost of overloading the left ventricle, whereas a new Pulsatile Ventricular Assist Platform could offer more physiological hemodynamic support.
Does a Pulsatile Ventricular Assist Platform (pVAP) with synchronized counter-pulsatile flow in a VA-ECMO configuration improve systemic and intraventricular hemodynamics compared to continuous-flow support and no support in porcine models of acute ischemic left ventricular failure?
Does a Pulsatile Ventricular Assist Platform (pVAP) with synchronized counter-pulsatile flow in a VA-ECMO configuration improve systemic and intraventricular hemodynamics compared to continuous-flow support and no support in porcine models of acute ischemic left ventricular failure?
Answers are grounded in this paper and cite their sources.
In a porcine model of acute ischemic heart failure, a novel Pulsatile Ventricular Assist Platform in a VA-ECMO configuration provided stable hemodynamic support and improved left ventricular afterload and ventricular-arterial coupling when using synchronized counter-pulsatile flow.
Background and aims Mortality from heart failure is still high despite all the recent advances. Continuous-flow (CF) Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) can temporarily maintain systemic and pulmonary hemodynamics, at the cost of overloading the left ventricle (LV). A new Pulsatile Ventricular Assist Platform (pVAP) could offer a more physiological hemodynamic support. Methods 6 large porcine models of acute ischemic left ventricular (LV) failure received the pVAP in a VA-ECMO configuration. Invasive systemic and intraventricular hemodynamic measurements were taken with synchronized counter-pulsatile flow (SCPF) and CF support at the same flow rate. The measurements were compared with no support (ON vs OFF) in both modalities. Results The pVAP successfully delivered VA-ECMO in acute ischemic heart failure. The device maintained stable hemodynamics and increased the forward cardiac output (CO F ) without overloading the LV and with no change in the LV pressure-volume area (PVA). SCPF, but not CF, was associated with improved LV afterload and ventricular-arterial coupling compared to no support. Conclusion The findings suggest that the pVAP is feasible also in a VA-ECMO configuration, supporting hemodynamics with more physiological effect on effect on the LV dynamics.
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Bastos et al. (2026) studied Acute ischemic left ventricular failure (n=6). Pulsatile Ventricular Assist Platform (pVAP) with synchronized counter-pulsatile flow (SCPF) in VA-ECMO configuration vs. Continuous-flow (CF) support and no support (OFF) was evaluated on Invasive systemic and intraventricular hemodynamic measurements (forward cardiac output, LV pressure-volume area, LV afterload, and ventricular-arterial coupling). The Pulsatile Ventricular Assist Platform in VA-ECMO (n=6 pigs) increased forward cardiac output without LV overload, and synchronized counter-pulsatile flow improved LV afterload vs no support.
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