Table 7.

Comparison of mechanical circulatory support system

	IABP	IMPELLA	VA-ECMO
Cardiac flow	0.3–0.5 L/min	1–5 L/min (Impella 2.5, Impella CP, Impella 5)	3–7 L/min
Mechanism	Aorta	LV → Ao	RA → Ao
Maximum implant days	Weeks	7 days	Weeks
Sheath size	7–8 Fr	13–14 Fr Impella 5.0—21 Fr	14–16 Fr arterial 18–21 Fr venous
Femoral artery size	> 4 mm	Impella 2.5 and CP: 5–5.5 mm Impella 5: 8 mm	8 mm
Cardiac synchrony or stable rhythm	Yes	No	No
Afterload	↓	↓	↑↑↑
Mean arterial pressure	↑	↑↑	↑↑
LVEDP	↓	↓↓	⟷
PCWP	↓	↓↓	⟷
LV preload	–	↓↓	↓
Coronary perfusion	↑	↑	–
Myocardial oxygen demand	↓	↓↓	⟷

Modified from [167]

Ao aorta, IABP intra-aortic balloon pump, LA left atrium, LV left ventricle, LVEDP left ventricular end diastolic pressure, RA right atrium, PCWP pulmonary capillary wedge pressure, VA-ECMO  venoarterial extracorporeal membrane oxygenation