Fig. 7

Impact of ECPELLA on BVF with PH haemodynamics. Changes in CO (A), total systemic flow (B), mean AP (C), RAP (D), and LAP (E) are shown. An asterisk (*) indicates that the corresponding axis has been inverted to clarify or highlight specific relationships. Since the PH further reduced LV filling, an increase in Impella support level excessively reduced LAP, induced LV suction, and limited the Impella support level (less than 1.6 L/min) in each VA-ECMO flow condition. BVF biventricular failure, PH pulmonary hypertension, VA-ECMO veno-arterial extracorporeal membrane oxygenation, CO cardiac output, AP arterial pressure, RAP right atrial pressure, LAP left atrial pressure