{"doi":"10.1002/ccd.30951","title":"Left ventricular hemodynamics with veno‐arterial extracorporeal membrane oxygenation","abstract":"BACKGROUND: There is considerable debate about the hemodynamic effects of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). AIMS: To evaluate the changes in left ventricular (LV) function, volumes, and work in patients treated with VA-ECMO using invasive LV catheterization and three-dimensional echocardiographic volumes. METHODS: Patients on VA-ECMO underwent invasive hemodynamic evaluation due to concerns regarding candidacy for decannulation. Hemodynamic parameters were reported as means±standard deviations or medians (interquartile ranges) after evaluating for normality. Paired comparisons were done to evaluate hemodynamics at the baseline (highest) and lowest tolerated levels of VA-ECMO support. RESULTS: Twenty patients aged 52.3 ± 15.8 years were included. All patients received VA-ECMO for refractory cardiogenic shock (5/20 SCAI stage D, 15/20 SCAI stage E). At 3.0 (2.0, 4.0) days after VA-ECMO cannulation, the baseline LV ejection fraction was 20% (15%, 27%). The baseline and lowest VA-ECMO flows were 4.0 ± 0.6 and 1.5 ± 0.6 L/min, respectively. Compared to the lowest flow, full VA-ECMO support reduced LV end-diastolic volume [109 ± 81 versus 134 ± 93 mL, p = 0.001], LV end-diastolic pressure (14 ± 9 vs. 19 ± 9 mmHg, p < 0.001), LV stroke work (1858 ± 1413 vs. 2550 ± 1486 mL*mmHg, p = 0.002), and LV pressure-volume area (PVA) (4507 ± 1910 vs. 5193 ± 2388, p = 0.03) respectively. Mean arterial pressure was stable at the highest and lowest flows (80 ± 16 vs. 75 ± 14, respectively; p = 0.08) but arterial elastance was higher at the highest VA-ECMO flow (4.9 ± 2.2 vs lowest flow 2.7 ± 1.6; p < 0.001). CONCLUSIONS: High flow VA-ECMO support significantly reduced LV end-diastolic pressure, end-diastolic volume, stroke work, and PVA compared to minimal support. The Ea was higher and MAP was stable or minimally elevated on high flow.","journal":"Catheterization and Cardiovascular Interventions","year":2024,"id":430857,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9682,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":542707,"name":"Tamás Alexy","orcid":"0000-0001-8381-6299","position":1,"is_corresponding":false},{"id":367364,"name":"Jason A. Bartos","orcid":"0000-0003-0113-5305","position":2,"is_corresponding":false},{"id":1234251,"name":"Anthony Prisco","orcid":"0000-0003-2209-1831","position":3,"is_corresponding":false},{"id":483490,"name":"Marinos Kosmopoulos","orcid":"0000-0003-1005-9690","position":4,"is_corresponding":false},{"id":1104981,"name":"Valmiki Maharaj","orcid":"0000-0003-0442-0021","position":5,"is_corresponding":false},{"id":1234679,"name":"Alejandra Gutierrez Bernal","orcid":null,"position":6,"is_corresponding":false},{"id":1234252,"name":"Andrea Elliott","orcid":"0000-0002-3969-6848","position":7,"is_corresponding":false},{"id":945111,"name":"Santiago García","orcid":"0000-0003-3715-8082","position":8,"is_corresponding":false},{"id":471739,"name":"Ganesh Raveendran","orcid":"0000-0002-6030-9232","position":9,"is_corresponding":false},{"id":512195,"name":"Ranjit John","orcid":"0000-0003-3854-310X","position":10,"is_corresponding":false},{"id":230591,"name":"Daniel Burkhoff","orcid":"0000-0003-3995-2466","position":11,"is_corresponding":false},{"id":367365,"name":"Demetris Yannopoulos","orcid":"0000-0002-7131-2015","position":12,"is_corresponding":false},{"id":301659,"name":"Rajat Kalra","orcid":"0000-0002-8982-0595","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T01:59:20.861374Z","pmid":"38197216","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}