The Journal of ExtraCorporeal Technology No 57-1 | Page 32

26 A . Calhoun et al .: J Extra Corpor Technol 2025 , 57 , 24 – 31
Table 1 . Literature survey of Clinical , Hemodynamic , and Echocardiographic indications of LV distension that potentially trigger the mechanical LV unloading .
Author , Publication Date , Type , Ref #
Hemodynamic indications Echocardiographic indications Recommended LV unloading
Truby et al ., 2017 , RA , [ 1 ]
PAD > 25
LV blood stasis
TVMA
Ezad et al ., 2023 , RA , [ 2 ]
PCWP > 18 , or ALPP < 15
Increased LV dimensions , LV
IABP , TVMA
blood stasis , LV thrombus , No AV opening , LVOT VTI < 10 cm
Cevasco et al ., 2019 RA , [ 3 ]
PAD > 25 ; “ an elevated PCWP ”
LV distension , LV blood stasis , LV
TVMA , Surg Vent
thrombus , hypocontractile LV , No AV Opening
Lorusso et al ., 2021 GD , [ 5 ]
Moderate : CVP 12 – 16 , PCWP
Moderate : AV opening every 3 – 4
IABP , AS , Surg Vent , TVMA
18 – 25 ( moderate ); Severe : CVP Above 20 , PCWP above 25
beats , moderate LV / LA distension , moderate Echo Smoke , IVC over 2.5 cm dilated , IVC collapse less than 50 %; Severe : AV closed , Severe LV / LA distention , Severe Echo Smoke , IVC over 2.5 cm , no IVC collapse .
Kim et al ., 2023 , RT , [ 8 ]
Minimal ALPP
LV Blood Stasis , No AV Opening ,
TSLAV
Low ALPP
Park et al ., 2023 , RT , [ 9 ]
No Hemodynamic Criteria
No or Low AV Opening ,
TSLAV
Described
congestion score index
Cheng et al ., 2013 , CS , [ 10 ]
PCWP > 18
EF < 20 %, Low or No AV
TVMA
Opening , LV Distension , LV Blood Stasis , Echo Smoke
Hasde et al ., 2021 , RR , [ 12 ]
PAD > 25 , PCWP at least 20
Low or No AV opening
IABP , AS , Surg Vent
Thiele et al ., 2023 , RT , [ 17 ]
Lack of ALPP
No AV opening , increase in
IABP , TVMA
diameters and volume of LV , LVOT VTI < 10 cm
Assmann et al ., 2022 , GD , [ 18 ]
PAD > 25
LV Dilation
IABP , AS , Surg Vent , TVMA
Belohlavek et al ., 2021 , RA ,
ALPP < 15 , high LVEDP
High LV Filling Pressures by
TVMA
[ 19 ]
Doppler Echocardiography
Donker et al ., 2022 , Ed , [ 20 ]
Increased PAC Pressures ; Reduced
Echo Smoke , Low or No AV
TVMA
ALPP
opening
Gaisendrees et al ., 2021 , RR ,
Low ALPP
Echo Smoke , LVEDD at Least
TVMA
[ 21 ]
6.8 cm ( male ), 6.1 ( female )
Lim et al ., 2021 , RA , [ 22 ]
Rising PAP and PCWP , Reduced ALPP
LV Dilation , Echo Smoke , Low or No AV opening
TVMA
Lorusso et al ., 2022 , RR , [ 23 ] CVP 12 – 16 ( moderate ), above 20 ( severe ); ALPP : 8 – 10 ( moderate ), less than 8 or pulseless ( severe ); wedge ( PCWP ?): 20 – 25 ( moderate ), above 25 ( severe ), Scvo2 : 55 – 45 ( moderate ), under 45 ( severe )
LA / LV distension , Echo Smoke , IVC : 1.5 – 2.5 , above 2.5 for mild , moderate / severe
IABP , TVMA , Surg Vent
Lüsebrink et al ., 2023 , RA , [ 24 ]
No ALPP , Elevated PAP or PCWP
Closed AV , LV Blood Stasis
Multiple Discussed
Meani et al ., 2019 , RR , [ 25 ]
Moderate PCWP 18 – 25 , CVP
Moderate : AV opening every 3 – 4
IABP , TVMA
12 – 16 ; Severe : CVP > 20 , PCWP > 25 ; Low or No ALPP
beats , moderate LV / LA distension , moderate smoke like effect , IVC over 2.5 cm dilated , IVC collapse less than 50 %; Severe : AV closed , LV / LA distention , Severe smoke like effect , IVC over 2.5 cm , no IVC collapse
Nakajima et al ., 2021 , RR , [ 26 ]
ALPP < 20
Echo Smoke
TVMA
Piechura et al ., 2020 , RR , [ 27 ]
ALPP < 10
LV Dilation or Low or no AV opening
IABP , TVMA
Ricarte Bratti et al ., 2021 , RA , [ 28 ]
Elevated LV Filling Pressures , ALPP < 10
Increased LVEDD , increased E / E ’ ratio , Echo Smoke , LV Thrombus , Low or No AV Opening
IABP , AS , TVMA , Surg Vent
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