Fig. 11

Impact of ECPELLA on LV unloading. Data from protocols 1-3 (Figs. 3, 5 and 7) were used. Upper panels represent the impact of VA-ECMO flow changes on LVEDP, a marker of LV unloading, in LVF (A), BVF (B), and BVF with PH (C), and the comparison among the three conditions: VA-ECMO + Impella P6, VA-ECMO + Impella P2, and VA-ECMO alone. Lower panels represent the impact of Impella support levels on LVEDP in LVF (D), BVF (E), and BVF with PH (F), and the comparison among the three conditions: VA-ECMO 4 L/min + Impella, VAECMO 2 L/min + Impella, and Impella alone. the increase in VA-ECMO flow decreased LVEDP in LVF conditions while increasing it in BVF and BVF with PH conditions. In addition, RV failure enhances the LV unloading effect by ECPELLA. LVF, left ventricular failure; BVF, biventricular failure; PH, pulmonary hypertension; LVEDP, left ventricular end-diastolic pressure; VA-ECMO, veno-arterial extracorporeal membrane oxygenation