Table 5. Overview of mechanical circulatory support.
| Device | Draining | Outflow | Approved time of use | Studies |
|---|---|---|---|---|
| Acute MCS | ||||
| Impella RP | RA | PA | 14 d | n=30 (18 LVAD, 12 post-cardiac surgery), 30 d survival 73% (recover right) (208) |
| Tandem Heart | RA | PA | 4 d | n=46 (18 post-cardiac surgery, 12 myocardial infarction, 5 LVAD, 5 post HTX), in-hospital mortality 57% (209) |
| V-Pa ECMO | RA | PA | 30 d | Restricted to case series |
| V-A ECMO | RA | FA | 30 d | n=179 (70 post-cardiac surgery, 46 myocardial infarction), in-hospital mortality 39% (210) |
| CentriMag | RA | PA | 30 d | n=38 (14 myocardial infarction, 12 LVAD, 12 post-cardiac surgery), mean duration of support 13 d (1–60 d), in-hospital mortality 58%, 30 d (211) |
| Durable MCS | ||||
| Berlin Heart | RA | PA | – | Mostly children, restricted to case series |
| Heart Ware/Heart Mate 3 | RV | PA | – | Heart Ware (meta-analysis): n=56 (85% non-ischemic cardiomyopathy), 30-day mortality 9%, time on device 156 (IQR, 66–351), heart transplantation 46% (212) |
| Heart Mate 3: n=14 (50% DCM; 28% ICM), 9 patients died within 6 months, 1 successful heart transplantation, 8 patients continuing support for 266 (95–636 days) (213) | ||||
| Total artificial heart* | RA | PA (requires RV explantation) | – | n=450 (50% DCM, 20% ICM), 266 underwent heart transplantation, 12-month survival 53% (214) |
| BiVACOR* | Requires native cardiectomy | – | Pre-clinical | |
| RealHeart* | Requires native cardiectomy | – | Pre-clinical | |
| Carmat* | Requires native cardiectomy | – | Early feasibility trial approved | |
*, biventricular support devices. DCM, dilated cardiomyopathy; ECMO, extracorporeal membrane oxygenation; FA, femoral artery; ICM, ischemic cardiomyopathy; LVAD, left ventricular assist device; PA, pulmonary artery; RA, right atrium; RV, right ventricle; V-A, veno-arterial; V-Pa, veno-pulmonary arterial.