Feature | May 13, 2013| Dave Fornell

ECMO May Become the pVAD of the Future

There is a growing trend in the use of small, portable extracorporeal membrane oxygenation (ECMO) systems for hemodynamic support. In years past, ECMO systems were a tool of the operating room, primarily for bypass surgery. Older systems required a perfusionist to watch the machine 24 hours a day while it was in operation. Today’s ECMOs use consoles that are much easier to use and do not require a full-time person to monitor. Also, as the technology has been miniaturized, simplified and now uses a percutaneous access system, ECMOs are being used outside the OR, including the cath lab, when a large amount of support is needed that cannot be provided by IABPs or pVADs. 

“These are definitely being put in the cath lab more and will see increasing use in the cath lab in the future ­— that will become the norm,” said Alan L. Gass, M.D., medical director, heart failure, heart transplantation and mechanical circulatory support, Westchester Heart and Vascular, and associate professor of medicine, New York Medical College. 

“We have seen that trend and we are helping drive it,” said Luca Lombardi, M.D., chief medical officer, Maquet Cardiovascular. “The technology has evolved tremendously over the past few years to reduce the trauma to the patient. Just 10 years ago we had to do a full surgical exposure to access the vessels, but today the external diameter of the canula is percutaneous, between 1.2 mm for pediatrics and up to 5 mm for adults.”

Gass has experience with both the Maquet CardioHelp and Thoratec CentriMag extracorporeal circulatory support devices. 

The CardioHelp is the world’s smallest circulatory and/or pulmonary support system, weighing just 22 pounds. It can be carried by one person and can be used inside or outside the hospital, including for patient transport. It offers an easy-to-use, touch-screen console interface and plug-and-play setup. Gass said the system offers 3 to 5 lpm of flow, so in patients who need more support than an IABP, he often uses this system as the next step up. 

“It’s a great little system with everything you need put into a small package,” Gass said. 

His only criticism of the CardioHelp is the inability to see if clots are forming in the oxygenator. 

The CentriMag pump is also very small, lightweight and easily transportable. Thoretec says the system can deliver up to 9.9 lpm of flow. The pump has no bearings, but instead uses magnetic levitation, which the vendor says reduced hemolysis (destruction of red blood cells) and the likelihood of mechanical pump failure. 

Related Content

Sponsored Content | Videos | Cardiovascular Ultrasound| July 19, 2017
This video educational session, provided in partnership with the American Society of Echocardiography (ASE), is title
First Patient Treated in U.S. Feasibility Study of LimFlow Critical Limb Ischemia Device
News | Peripheral Arterial Disease (PAD)| July 17, 2017
LimFlow SA announced enrollment of the first patient in the U.S. feasibility study of the LimFlow Percutaneous Deep...
FDA Approves Six-Month Primary Endpoint for Tack Endovascular System in Below the Knee Disease
News | Stents Peripheral| July 14, 2017
Intact Vascular Inc. announced the U.S. Food and Drug Administration (FDA) approved an Investigational Device Exemption...
Edwards Sapien 3 TAVR valve will be implanted in asymptomatic aortic stenosis patients in the EARLY TAVR Trial
Feature | Heart Valve Technology| July 14, 2017
July 14, 2017 — Morristown Medical Center, part of Atlantic Health System, has randomized the first patient in the wo
long-duration dual anti-platelet therapy (L-DAPT) compared to short-duration dual antiplatelet (S-DAPT) after DES stent implantation
News | Antiplatelet and Anticoagulation Therapies| July 12, 2017
June 12, 2017 — Researchers have evaluated the long-term efficacy and safety of long-duration dual anti-platelet ther
Medtronic's CoreValve Evolut R gained FDA approval for intermediate risk patients

An illustration of the self-expanding CoreValve Evolut R TAVR valve half deployed in the aortic root.

Feature | Heart Valve Technology| July 10, 2017
The U.S. Food and Drug Administration (FDA) has cleared an additional indication to expand the use Medtronic's self-...
Patient Race, Gender Both Important in Predicting Heart Attack Symptoms in the ER
News | Cath Lab| July 07, 2017
Researchers at the George Washington University (GW) found that certain symptoms are more and less predictive of...
ACCESS PTS Study Demonstrates Efficacy of EKOS Therapy for Post-Thrombotic Syndrome
News | Deep Vein Thrombosis| July 07, 2017
BTG plc recently highlighted the results of the ACCESS PTS trial, presented at the Society for Vascular Medicine 28th...
Heartflow FFR-CT can noninvasively assess the hemodynamic impact of coronary lesions to avoid the need for an invasive angiogram.

HeartFlow FFR-CT can noninvasively assess the hemodynamic impact of coronary lesions to avoid the need for an invasive angiogram.

Technology | CT Angiography (CTA)| July 06, 2017
July 6, 2017 — GE Healthcare and HeartFlow Inc.
Pre-PCI Impella 2.5 Insertion Improves Survival in Left Main Coronary Artery Heart Attacks
News | Ventricular Assist Devices (VAD)| June 30, 2017
Abiomed Inc. announced the recent publication of a peer-reviewed retrospective study on hemodynamic support with the...
Overlay Init