Fig. 4

Impact of ECPELLA on right and left ventricular PV loops on LVF haemodynamics. Three conditions of MCS are shown: Impella alone (A), 2.0 mL/min of VA-ECMO with Impella (B), and 4.0 mL/min of VA-ECMO with Impella (C). Different conditions are represented by various colours (black line: baseline, yellow: supported with Impella P2, red: Impella P6). In the RV-PV loop, both VA-ECMO and Impella rendered the RV-PV loop left downward in each ECPELLA support condition. In the LV-PV loop, VA-ECMO shifted the LV-PV loop downward to the left only in the higher Impella support conditions (P6). PV loop pressure–volume loop, LVF left ventricular failure, VA-ECMO veno-arterial extracorporeal membrane oxygenation, RVP right ventricular pressure, RVV right ventricular volume, LVP left ventricular pressure, LVV left ventricular volume