Table 3: Temporary mechanical circulatory support devices.

MCS Device	IABP	Impella 2.5/CP/5.5	TandemHeart	VA-ECMO
CO (L/min)	0.5–1.0	2.5/3.0–4.0/5.0	4.0–5.0	4.0–10.0
Haemodynamic effects	LV pressure or volume unloading	LV pressure or volume unloading	LV volume unloading	Biventricular pressure and volume unloading
Peripheral resistance	Decreased	Decreased	Mildly increased	Highly increased
LV unloading	+	++	++	–
Pump mechanism	Pneumatic	Axial flow	Centrifugal	Centrifugal
Cannula size	7–9 Fr	13–22 Fr	Drainage 21 Fr; Return 15–17 Fr	Drainage 18–21 Fr; Return 15–22 Fr
Advantages	Bedside insertion; no anticoagulation	Direct ventricular unloading	Addition of pulmonary support	Addition of pulmonary support
Disadvantages	Minimal haemodynamic support	Mandatory anticoagulation; haemolysis	Immobilization	Incomplete LV unloading
Complications	Limb/spinal cord ischaemia; bleeding; aortic dissection	Limb ischaemia; bleeding; haemolysis; ventricular arrhythmias	Cardiac perforation; tamponade bleeding; air embolism; residual ASD	Limb ischaemia; bleeding; stroke; air embolism; circuit clots; DIC; oxygenator failure; altered drug pharmacokinetics
Contraindications	Severe PAD; AAA; significant AI	LV thrombus; mechanical AV; severe PAD	VSD; significant AI; left atrial thrombus	Severe PAD; significant AI; aortic dissection

AAA = abdominal aortic aneurysm; AI = aortic insufficiency; ASD = atrial septal defect; AV = aortic valve; CO = cardiac output; DIC = disseminated intravascular coagulation; ECMO = extracorporeal membrane oxygenation; IABP = intra-aortic balloon pump; LV = left ventricle; PAD = peripheral arterial disease; VA = venoarterial; VSD = ventricular septal defect.