Fig. 3

Impact of ECPELLA on LVF haemodynamics. Changes in CO (A), total systemic flow (B), mean AP (C), RAP (D), and LAP (E) are shown. Each simulation consists of a series of 10 plots (Impella support at P0 ➝ P1 ➝・・・➝P9) corresponding to a single varied setting, from which 11 sets of data (VA-ECMO flow at 0➝0.5➝・・・➝5.0 L/min) were used to construct the plots. An increase in VA-ECMO flow decreased CO and increased total systemic flow and mean AP. The addition of Impella decreased CO and increased total systemic flow and mean AP, while maintaining RAP and reducing LAP. Under total ECPELLA support, i.e. zero CO, an increase in Impella support level effectively increased total systemic flow and mean AP, and markedly decreased LAP. LVF left ventricular failure, VA-ECMO veno-arterial extracorporeal membrane oxygenation, CO cardiac output, AP arterial pressure, RAP right atrial pressure, LAP left atrial pressure