{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:33:09Z","timestamp":1788413589056,"version":"build-2803163510"},"reference-count":120,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Mechanical circulatory support (MCS) is increasingly utilized for the management of acute decompensated heart failure (HF) and cardiogenic shock (CS). The primary goals of MCS are to restore systemic perfusion, reduce cardiac workload, and support end-organ function. A thorough understanding of cardiovascular physiology in patients supported by MCS is essential for clinical decision-making. This review summarizes current evidence on the physiological effects of various MCS devices, key monitoring techniques, patient management, and explores the emerging role of artificial intelligence (AI) in this field. Main Text: Short-term MCS devices include intra-aortic balloon pumps (IABP), percutaneous left-sided devices such as Impella (Abiomed, Danvers, MA, USA) and TandemHeart (LivaNova, London, UK), percutaneous right-sided support devices like Protek Duo (LivaNova, London, UK) and Impella RP Flex (Abiomed, Danvers, MA, USA), and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Long-term support is mainly provided by left ventricular assist devices (LVADs), including the HeartMate 3 (Abbott Laboratories, Chicago, IL, USA). Optimal MCS application requires an understanding of device-specific cardiovascular interactions and expertise in appropriate monitoring tools to assess device performance and patient response. The choice of device, timing of initiation, and patient selection must be individualized, with careful consideration of ethical implications. The integration of AI offers significant potential to advance clinical care by improving complication prediction, enabling real-time optimization of device settings, and refining patient selection criteria. Conclusions: MCS is a rapidly evolving field that requires a comprehensive understanding of cardiovascular interactions, careful selection of monitoring strategies, and individualized clinical management. Future research should address current device limitations, clarify device-specific clinical applications, and assess the validity of AI-driven technologies.<\/jats:p>","DOI":"10.3390\/jcm14196935","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:16:29Z","timestamp":1759241789000},"page":"6935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiovascular Physiology During Mechanical Circulatory Support: Implications for Management and Monitoring"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8011-4654","authenticated-orcid":false,"given":"Ettore","family":"Crimi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karuna","family":"Rajkumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Coleman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0104-3291","authenticated-orcid":false,"given":"Rohesh","family":"Fernando","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Marchant","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrika","family":"Garner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gaillard","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"},{"name":"Department of Emergency Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan H.","family":"Hicks","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6234-6160","authenticated-orcid":false,"given":"Ryan C.","family":"Maves","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"},{"name":"Department of Internal Medicine, Section of Infectious Diseases, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"},{"name":"Center for Bioethics, Health, and Society, Wake Forest University, Winston-Salem, NC 27109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9083-891X","authenticated-orcid":false,"given":"Ashish K.","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA"},{"name":"Outcomes Research Consortium, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","first-page":"e876","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.jacc.2022.01.018","article-title":"SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021","volume":"79","author":"Naidu","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/j.jacc.2025.02.018","article-title":"2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Evaluation and Management of Cardiogenic Shock","volume":"85","author":"Sinha","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1161\/CIRCULATIONAHA.123.064527","article-title":"Standardized Definitions for Cardiogenic Shock Research and Mechanical Circulatory Support Devices: Scientific Expert Panel from the Shock Academic Research Consortium (SHARC)","volume":"148","author":"Pahuja","year":"2023","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1097\/CCM.0000000000002676","article-title":"Advanced Percutaneous Mechanical Circulatory Support Devices for Cardiogenic Shock","volume":"45","author":"Miller","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1056\/NEJMoa2312572","article-title":"Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock","volume":"390","author":"Jensen","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1161\/CIR.0000000000001076","article-title":"Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement from the American Heart Association","volume":"146","author":"Geller","year":"2022","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.cardfail.2023.09.003","article-title":"Outcomes of Patients Transferred to Tertiary Care Centers for Treatment of Cardiogenic Shock: A Cardiogenic Shock Working Group Analysis","volume":"30","author":"Garan","year":"2024","journal-title":"J. Card. Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/S0140-6736(24)01448-X","article-title":"Temporary mechanical circulatory support in infarct-related cardiogenic shock: An individual patient data meta-analysis of randomised trials with 6-month follow-up","volume":"404","author":"Thiele","year":"2024","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1016\/j.jacc.2015.03.036","article-title":"2015 SCAI\/ACC\/HFSA\/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d\u2019intervention","volume":"65","author":"Rihal","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Manolis, A.A., Manolis, T.A., and Manolis, A.S. (2023). Neurohumoral Activation in Heart Failure. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242015472"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5566","DOI":"10.3892\/ijmm.2025.5566","article-title":"Molecular mechanisms and intervention approaches of heart failure (Review)","volume":"56","author":"Guo","year":"2025","journal-title":"Int. J. Mol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/0002-8703(87)90318-8","article-title":"Predicting survival for an individual with congestive heart failure using the plasma norepinephrine concentration","volume":"114","author":"Rector","year":"1987","journal-title":"Am. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Pamias-Lopez, B., Ibrahim, M.E., and Pitoulis, F.G. (2023). Cardiac mechanics and reverse remodelling under mechanical support from left ventricular assist devices. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1212875"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1093\/eurheartj\/ehz363","article-title":"Management of cardiogenic shock complicating myocardial infarction: An update 2019","volume":"40","author":"Thiele","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_17","first-page":"170","article-title":"Physiology of the Assisted Circulation in Cardiogenic Shock: A State-of-the-Art Perspective","volume":"36","author":"Guihaire","year":"2020","journal-title":"Can. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"37","DOI":"10.17925\/HI.2022.16.1.37","article-title":"A Comprehensive Review of Mechanical Circulatory Support Devices","volume":"16","author":"Atti","year":"2022","journal-title":"Heart Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.1016\/j.jacc.2015.10.017","article-title":"Hemodynamics of Mechanical Circulatory Support","volume":"66","author":"Burkhoff","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1213\/ANE.0000000000004954","article-title":"Intraaortic Balloon Pump Counterpulsation, Part I: History, Technical Aspects, Physiologic Effects, Contraindications, Medical Applications\/Outcomes","volume":"131","author":"Chaney","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1038\/s41569-022-00796-5","article-title":"Temporary mechanical circulatory support devices: Practical considerations for all stakeholders","volume":"20","author":"Salter","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"586","DOI":"10.4244\/EIJ-D-19-00254","article-title":"Primary intra-aortic balloon support versus inotropes for decompensated heart failure and low output: A randomised trial","volume":"15","author":"Bastos","year":"2019","journal-title":"EuroIntervention"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/SHK.0b013e31824a67af","article-title":"Hemodynamic effects of intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: The prospective, randomized IABP shock trial","volume":"37","author":"Prondzinsky","year":"2012","journal-title":"Shock"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1161\/CIRCULATIONAHA.118.038201","article-title":"Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial","volume":"139","author":"Thiele","year":"2019","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1080\/17434440.2024.2436122","article-title":"A profile of the impella 5.5 for the clinical management of cardiogenic shock and a review of the current indications for use and future directions","volume":"21","author":"Hershenhouse","year":"2024","journal-title":"Expert. Rev. Med. Devices"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Masiero, G., Arturi, F., Panza, A., and Tarantini, G. (2024). Mechanical Circulatory Support with Impella: Principles, Evidence, and Daily Practice. J. Clin. Med., 13.","DOI":"10.3390\/jcm13164586"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"469.e1","DOI":"10.1016\/j.ahj.2006.05.031","article-title":"A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock","volume":"152","author":"Burkhoff","year":"2006","journal-title":"Am. Heart J."},{"key":"ref_28","first-page":"447","article-title":"Clinical experience with the TandemHeart percutaneous ventricular assist device as a bridge to cardiac transplantation","volume":"35","author":"Bruckner","year":"2008","journal-title":"Tex. Heart Inst. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s11897-022-00562-1","article-title":"Right-Sided Mechanical Circulatory Support\u2014A Hemodynamic Perspective","volume":"19","author":"Alkhunaizi","year":"2022","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1016\/j.healun.2024.07.006","article-title":"Pragmatic approach to temporary mechanical circulatory support in acute right ventricular failure","volume":"43","author":"Carnicelli","year":"2024","journal-title":"J. Heart Lung Transpl."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.cardfail.2016.10.012","article-title":"Extracorporeal Life Support: Physiological Concepts and Clinical Outcomes","volume":"23","author":"Lim","year":"2017","journal-title":"J. Card. Fail."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/ALN.0000000000003876","article-title":"Management of Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock","volume":"135","author":"Patel","year":"2021","journal-title":"Anesthesiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jchf.2018.05.019","article-title":"Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock","volume":"6","author":"Rao","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1161\/CIRCULATIONAHA.122.062371","article-title":"Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How?","volume":"147","author":"Ezad","year":"2023","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.jchf.2018.09.009","article-title":"Unloading of the Left Ventricle During Venoarterial Extracorporeal Membrane Oxygenation Therapy in Cardiogenic Shock","volume":"6","author":"Schrage","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_36","first-page":"228","article-title":"Extracorporeal cardiopulmonary resuscitation for cardiac arrest","volume":"26","author":"Kalra","year":"2020","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2776","DOI":"10.1053\/j.jvca.2019.12.047","article-title":"Clinical Management of Venoarterial Extracorporeal Membrane Oxygenation","volume":"34","author":"Hoyler","year":"2020","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.4187\/respcare.10929","article-title":"Extracorporeal Membrane Oxygenation","volume":"68","author":"Wheeler","year":"2023","journal-title":"Respir. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1056\/NEJMoa1610426","article-title":"A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure","volume":"376","author":"Mehra","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.cardfail.2021.11.016","article-title":"Physiology and Clinical Utility of HeartMate Pump Parameters","volume":"28","author":"Belkin","year":"2022","journal-title":"J. Card. Fail."},{"key":"ref_41","first-page":"2125","article-title":"Blood pressure management in mechanical circulatory support","volume":"7","author":"Bennett","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_42","first-page":"S52","article-title":"Right heart failure post left ventricular assist device implantation","volume":"6","author":"Argiriou","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1053\/j.jvca.2017.11.003","article-title":"Implantable Left Ventricular Assist Device Therapy-Recent Advances and Outcomes","volume":"32","author":"Stone","year":"2018","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1002\/ejhf.2327","article-title":"Guidance on the management of left ventricular assist device (LVAD) supported patients for the non-LVAD specialist healthcare provider: Executive summary","volume":"23","author":"Milicic","year":"2021","journal-title":"Eur. J. Heart Fail."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chaudhry, S.P., DeVore, A.D., Vidula, H., Nassif, M., Mudy, K., Birati, E.Y., Gong, T., Atluri, P., Pham, D., and Sun, B. (2022). Left Ventricular Assist Devices: A Primer for the General Cardiologist. J. Am. Heart Assoc., 11.","DOI":"10.1161\/JAHA.122.027251"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/j.healun.2018.08.008","article-title":"An international multicenter experience of biventricular support with HeartMate 3 ventricular assist systems","volume":"37","author":"Lavee","year":"2018","journal-title":"J. Heart Lung Transplant."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s10741-020-09971-7","article-title":"Outcomes of percutaneous temporary biventricular mechanical support: A systematic review","volume":"27","author":"Weber","year":"2022","journal-title":"Heart Fail. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Loardi, C.M., Zanobini, M., Ricciardi, G., and Vermes, E. (2023). Current and future options for adult biventricular assistance: A review of literature. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1234516"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Yin, E.B. (2023). Anticoagulation Management in Temporary Mechanical Circulatory Support Devices. Tex. Heart Inst. J., 50.","DOI":"10.14503\/THIJ-23-8135"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.cardfail.2024.07.013","article-title":"Anticoagulation Medications, Monitoring, and Outcomes in Patients with Cardiogenic Shock Requiring Temporary Mechanical Circulatory Support","volume":"30","author":"Mehta","year":"2024","journal-title":"J. Card. Fail."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.cardfail.2021.08.010","article-title":"Heart Failure-Related Cardiogenic Shock: Pathophysiology, Evaluation and Management Considerations: Review of Heart Failure-Related Cardiogenic Shock","volume":"27","author":"Abraham","year":"2021","journal-title":"J. Card. Fail."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1161\/CIRCULATIONAHA.111.060830","article-title":"Mechanical circulatory support for advanced heart failure: Patients and technology in evolution","volume":"125","author":"Stewart","year":"2012","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.healun.2022.12.004","article-title":"The 2023 International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: A 10-Year Update","volume":"42","author":"Saeed","year":"2023","journal-title":"J. Heart Lung Transpl."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1001\/jama.1968.03140020041011","article-title":"Initial clinical experience with intraaortic balloon pumping in cardiogenic shock","volume":"203","author":"Kantrowitz","year":"1968","journal-title":"JAMA"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.amjcard.2005.11.070","article-title":"Intra-aortic balloon counterpulsation","volume":"97","author":"Trost","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/S0735-1097(01)01553-4","article-title":"The current practice of intra-aortic balloon counterpulsation: Results from the Benchmark Registry","volume":"38","author":"Ferguson","year":"2001","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_57","first-page":"75","article-title":"Temporary mechanical circulatory support: A review of the options, indications, and outcomes","volume":"8","author":"Gilotra","year":"2014","journal-title":"Clin. Med. Insights Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1056\/NEJMoa1208410","article-title":"Intraaortic balloon support for myocardial infarction with cardiogenic shock","volume":"367","author":"Thiele","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/S0140-6736(13)61783-3","article-title":"Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): Final 12 month results of a randomised, open-label trial","volume":"382","author":"Thiele","year":"2013","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e771","DOI":"10.1161\/CIR.0000000000001328","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"151","author":"Rao","year":"2025","journal-title":"Circulation"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Authors\/Task Force Members, Windecker, S., Kolh, P., Alfonso, F., Collet, J.P., Cremer, J., Falk, V., Filippatos, G., Hamm, C., and Head, S.J. (2014). 2014 ESC\/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur. Heart J., 35, 2541\u20132619.","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/jocs.13114","article-title":"Preoperative intra-aortic balloon pump use in high-risk patients prior to coronary artery bypass graft surgery decreases the risk for morbidity and mortality-A meta-analysis of 9,212 patients","volume":"32","author":"Deppe","year":"2017","journal-title":"J. Card. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1055\/s-0038-1676369","article-title":"The Impella Device: Historical Background, Clinical Applications and Future Directions","volume":"28","author":"Glazier","year":"2019","journal-title":"Int. J. Angiol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Attinger-Toller, A., Bossard, M., Cioffi, G.M., Tersalvi, G., Madanchi, M., Bloch, A., Kobza, R., and Cuculi, F. (2022). Ventricular Unloading Using the Impella(TM) Device in Cardiogenic Shock. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.856870"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1186\/s13019-020-01251-7","article-title":"The role of the axillary Impella 5.0 device on patients with acute cardiogenic shock","volume":"15","author":"Tarabichi","year":"2020","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ijcard.2020.09.044","article-title":"Short term outcomes of Impella in cardiogenic shock: A review and meta-analysis of observational studies","volume":"324","author":"Iannaccone","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1097\/IMI.0000000000000535","article-title":"Outcomes of Impella 5.0 in Cardiogenic Shock: A Systematic Review and Meta-analysis","volume":"13","author":"Batsides","year":"2018","journal-title":"Innovations"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.healun.2023.01.011","article-title":"Improved clinical outcomes associated with the Impella 5.5 compared to the Impella 5.0 in contemporary cardiogenic shock and heart failure patients","volume":"42","author":"Ramzy","year":"2023","journal-title":"J. Heart Lung Transpl."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.amjcard.2013.09.008","article-title":"Impact of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump on prognostically important clinical outcomes in patients undergoing high-risk percutaneous coronary intervention (from the PROTECT II randomized trial)","volume":"113","author":"Dangas","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1161\/CIRCULATIONAHA.118.036614","article-title":"Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock","volume":"139","author":"Schrage","year":"2019","journal-title":"Circulation"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.jacc.2018.11.038","article-title":"Venoarterial ECMO for Adults: JACC Scientific Expert Panel","volume":"73","author":"Guglin","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Rao, P., Khalpey, Z., Smith, R., Burkhoff, D., and Kociol, R.D. (2018). Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest. Circ. Heart Fail., 11.","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.amjcard.2023.09.023","article-title":"Left Ventricular Unloading with Impella Versus IABP in Patients With VA-ECMO: A Systematic Review and Meta-Analysis","volume":"208","author":"Gandhi","year":"2023","journal-title":"Am. J. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"482","DOI":"10.4244\/EIJ-D-23-00204","article-title":"Venoarterial extracorporeal membrane oxygenation or standard care in patients with cardiogenic shock complicating acute myocardial infarction: The multicentre, randomised EURO SHOCK trial","volume":"19","author":"Banning","year":"2023","journal-title":"EuroIntervention"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1056\/NEJMoa2307227","article-title":"Extracorporeal Life Support in Infarct-Related Cardiogenic Shock","volume":"389","author":"Thiele","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1097\/CCM.0000000000000920","article-title":"Extracorporeal membrane oxygenation for the support of adults with acute myocarditis","volume":"43","author":"Diddle","year":"2015","journal-title":"Crit. Care Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.hlc.2018.10.006","article-title":"Mechanical Circulatory Support During Catheter Ablation of Ventricular Tachycardia: Indications and Options","volume":"28","author":"Virk","year":"2019","journal-title":"Heart Lung Circ."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/SHK.0000000000001996","article-title":"Impella Versus Extracorporeal Membrane Oxygenation in Cardiogenic Shock: A Systematic Review and Meta-Analysis","volume":"58","author":"Abusnina","year":"2022","journal-title":"Shock"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.amjcard.2022.06.059","article-title":"Meta-Analysis Comparing Venoarterial Extracorporeal Membrane Oxygenation with or Without Impella in Patients with Cardiogenic Shock","volume":"181","author":"Bhatia","year":"2022","journal-title":"Am. J. Cardiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/heartjnl-2020-317886","article-title":"Implantable left ventricular assist device: Indications, eligibility and current outcomes","volume":"108","author":"Bhagra","year":"2022","journal-title":"Heart"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"3224","DOI":"10.1053\/j.jvca.2024.08.016","article-title":"HeartMate 3: Analysis of Outcomes and Future Directions","volume":"38","author":"Ripoll","year":"2024","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1056\/NEJMoa1900486","article-title":"A Fully Magnetically Levitated Left Ventricular Assist Device\u2014Final Report","volume":"380","author":"Mehra","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1093\/eurheartj\/ehad658","article-title":"Fully magnetically centrifugal left ventricular assist device and long-term outcomes: The ELEVATE registry","volume":"45","author":"Schmitto","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"293","DOI":"10.5603\/CJ.a2021.0172","article-title":"Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions","volume":"29","author":"Castrodeza","year":"2022","journal-title":"Cardiol. J."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Rodenas-Alesina, E., Brahmbhatt, D.H., Rao, V., Salvatori, M., and Billia, F. (2022). Prediction, prevention, and management of right ventricular failure after left ventricular assist device implantation: A comprehensive review. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.1040251"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.athoracsur.2017.08.019","article-title":"Biventricular Support with Intracorporeal, Continuous Flow, Centrifugal Ventricular Assist Devices","volume":"105","author":"Milano","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.jchf.2023.04.007","article-title":"Pulmonary Artery Catheter Use and Mortality in the Cardiac Intensive Care Unit","volume":"11 Part 1","author":"Kadosh","year":"2023","journal-title":"JACC Heart Fail."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1016\/j.cardfail.2023.05.001","article-title":"Pulmonary Artery Catheter Use and Risk of In-hospital Death in Heart Failure Cardiogenic Shock","volume":"29","author":"Kanwar","year":"2023","journal-title":"J. Card. Fail."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.jchf.2020.08.012","article-title":"Complete Hemodynamic Profiling with Pulmonary Artery Catheters in Cardiogenic Shock Is Associated with Lower In-Hospital Mortality","volume":"8","author":"Garan","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Owyang, C.G., Rippon, B., Teran, F., Brodie, D., Araos, J., Burkhoff, D., Kim, J., and Tonna, J.E. (2023). Pulmonary Artery Pressures and Mortality during VA ECMO: An ELSO Registry Analysis. medRxiv.","DOI":"10.1101\/2023.08.08.23293859"},{"key":"ref_91","first-page":"230","article-title":"Monitoring during extracorporeal membrane oxygenation","volume":"22","author":"Doufle","year":"2016","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.echo.2024.06.005","article-title":"Recommendations for Multimodality Imaging of Patients with Left Ventricular Assist Devices and Temporary Mechanical Support: Updated Recommendations from the American Society of Echocardiography","volume":"37","author":"Estep","year":"2024","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"253","DOI":"10.31083\/j.rcm2307253","article-title":"Echocardiography in Cardiac Assist Devices","volume":"23","author":"Anand","year":"2022","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/echo.15266","article-title":"Echocardiography for extracorporeal membrane oxygenation","volume":"39","author":"Hussey","year":"2022","journal-title":"Echocardiography"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/s13054-022-04249-w","article-title":"Parameters associated with successful weaning of veno-arterial extracorporeal membrane oxygenation: A systematic review","volume":"26","author":"Charbonneau","year":"2022","journal-title":"Crit. Care"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"792","DOI":"10.21037\/atm.2020.03.186","article-title":"Hemodynamic monitoring in patients with venoarterial extracorporeal membrane oxygenation","volume":"8","author":"Su","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1536\/ihj.51.116","article-title":"End-tidal carbon dioxide concentration can estimate the appropriate timing for weaning off from extracorporeal membrane oxygenation for refractory circulatory failure","volume":"51","author":"Naruke","year":"2010","journal-title":"Int. Heart J."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"393258","DOI":"10.1155\/2014\/393258","article-title":"Monitoring of the adult patient on venoarterial extracorporeal membrane oxygenation","volume":"2014","author":"Chung","year":"2014","journal-title":"Sci. World J."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"49s","DOI":"10.1177\/02676591241238156","article-title":"The intricate physiology of veno-venous extracorporeal membrane oxygenation: An overview for clinicians","volume":"39","author":"Tomarchio","year":"2024","journal-title":"Perfusion"},{"key":"ref_100","first-page":"17","article-title":"Interaction between VA-ECMO and the right ventricle","volume":"68","author":"Puerto","year":"2022","journal-title":"Hell. J. Cardiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1161\/CIRCULATIONAHA.121.056600","article-title":"Distinct Transcriptomic and Proteomic Profile Specifies Patients Who Have Heart Failure with Potential of Myocardial Recovery on Mechanical Unloading and Circulatory Support","volume":"147","author":"Drakos","year":"2023","journal-title":"Circulation"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1161\/CIRCULATIONAHA.120.046415","article-title":"Prospective Multicenter Study of Myocardial Recovery Using Left Ventricular Assist Devices (RESTAGE-HF [Remission from Stage D Heart Failure]): Medium-Term and Primary End Point Results","volume":"142","author":"Birks","year":"2020","journal-title":"Circulation"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1093\/eurheartj\/ehz124","article-title":"Mode-of-action of the PROPELLA concept in fulminant myocarditis","volume":"40","author":"Spillmann","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1177\/10499091211041079","article-title":"Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice","volume":"39","author":"Piscitello","year":"2022","journal-title":"Am. J. Hosp. Palliat. Care"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Wirpsa, M.J., Carabini, L.M., Neely, K.J., Kroll, C., and Wocial, L.D. (2021). Mitigating ethical conflict and moral distress in the care of patients on ECMO: Impact of an automatic ethics consultation protocol. J. Med. Ethics, 47.","DOI":"10.1136\/medethics-2020-106881"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1097\/CCM.0000000000004922","article-title":"Venoarterial Extracorporeal Membrane Oxygenation for Postcardiotomy Shock-Analysis of the Extracorporeal Life Support Organization Registry","volume":"49","author":"Kowalewski","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Tariq, M.D., Jain, H., Khan, A.M., Shahnoor, S., Goyal, P., Zulfiqar, E., Ahsan, A., Jaiswal, V., Daoud, M., and Sohail, A.H. (2024). Efficacy and safety of percutaneous mechanical circulatory support in patients with cardiogenic shock following acute myocardial infarction: A meta-analysis of randomized controlled trials. Medicine, 103.","DOI":"10.1097\/MD.0000000000040595"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1161\/CIRCULATIONAHA.122.062949","article-title":"Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial","volume":"147","author":"Ostadal","year":"2023","journal-title":"Circulation"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1016\/S0140-6736(23)01607-0","article-title":"Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: An individual patient data meta-analysis of randomised trials","volume":"402","author":"Zeymer","year":"2023","journal-title":"Lancet"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e226","DOI":"10.1097\/SLA.0000000000004838","article-title":"Escalation and Withdrawal of Treatment for Patients on Extracorporeal Membrane Oxygenation: A Qualitative Study","volume":"277","author":"Hadler","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.athoracsur.2020.08.045","article-title":"The Ethics of Extracorporeal Membrane Oxygenation: Revisiting the Principles of Clinical Bioethics","volume":"112","author":"Enumah","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e874","DOI":"10.1097\/CCM.0000000000006607","article-title":"Geospatial Access to Extracorporeal Membrane Oxygenation in the United States","volume":"53","author":"Gottula","year":"2025","journal-title":"Crit. Care Med."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"2246","DOI":"10.1093\/eurheartj\/ehv194","article-title":"Predicting survival after ECMO for refractory cardiogenic shock: The survival after veno-arterial-ECMO (SAVE)-score","volume":"36","author":"Schmidt","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Grzyb, C., Du, D., and Nair, N. (2024). Artificial Intelligence Approaches for Predicting the Risks of Durable Mechanical Circulatory Support Therapy and Cardiac Transplantation. J. Clin. Med., 13.","DOI":"10.3390\/jcm13072076"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.hfc.2021.11.005","article-title":"Artificial Intelligence and Mechanical Circulatory Support","volume":"18","author":"Li","year":"2022","journal-title":"Heart Fail. Clin."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.healun.2021.02.016","article-title":"Machine learning, artificial intelligence and mechanical circulatory support: A primer for clinicians","volume":"40","author":"Kanwar","year":"2021","journal-title":"J. Heart Lung Transpl."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jchf.2018.03.016","article-title":"A Bayesian Model to Predict Survival After Left Ventricular Assist Device Implantation","volume":"6","author":"Kanwar","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1002\/ejhf.1628","article-title":"Improving risk prediction in heart failure using machine learning","volume":"22","author":"Adler","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.echo.2019.04.001","article-title":"Machine Learning-Based Three-Dimensional Echocardiographic Quantification of Right Ventricular Size and Function: Validation Against Cardiac Magnetic Resonance","volume":"32","author":"Genovese","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1093\/jamia\/ocw112","article-title":"Using recurrent neural network models for early detection of heart failure onset","volume":"24","author":"Choi","year":"2016","journal-title":"J. Am. Med. Inform. Assoc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6935\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T04:11:46Z","timestamp":1759810306000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":120,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14196935"],"URL":"https:\/\/doi.org\/10.3390\/jcm14196935","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}